International Journal of Surgery and Surgical Sciences (IJSSS)
CASE SERIES ON EFFICACY OF PARACETAMOL FOR PDA CLOSURE IN PRETERM INFANTS
Abstract
Introduction: Persistence of Patent ductus arteriosus in preterm infants leads to serious clinical manifestations. We report here a case series of 15 preterm infants having hs-PDA, treated with paracetamol. Our series is unique because ibuprofen was used if PCM failed and finally surgical ligation/ device closure was done in whom ibuprofen also failed to close PDA. Also, there is a paucity of research papers on this from India.
Aims and Objectives: Primary aim is to see efficacy of paracetamol for PDA closure in preterm infants. Secondary aims are to analyse re-opening rate, safety profile of paracetamol, co-relation of PDA closure with paracetamol and gestation age, birth weight, age at presentation, size of PDA.
Material and Methods: Data was collected of a total of 15 preterm infants from January 2014 to June 2016. Paracetamol was given at a dose of 15 mg/kg/dose Q6H for maximum of 72 hours and maximum of two such courses were given. Those preterm babies in whom PDA was not closed even after two paracetamol courses, Ibuprofen was given at standard dose.
Results: Successful closure of hs-PDA after one course of PCM was done in 11 out of 15 babies (73%). Cumulative effect of PCM for ductal closure was 86.66 % after two courses. Regarding the safety profile of PCM, there was no significant increase in serum urea, creatinine, SGOT, SGPT and bilirubin levels after treatment with PCM. There was no significant co-relation found between successful closure of PDA with PCM and other factors, eg, size of PDA, gestational age, age at enrolment and birth weight.
Conclusion: The protocol that we used was effective and it can help to reduce the risk by exposing far fewer neonates to Ibuprofen/ IndomethacinKeywords
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