Comparative evaluation of the effects of indomethacin and ibuprofen on cerebral perfusion and oxygenation in preterm infants with patent ductus arteriosus☆,☆☆
Section snippets
Patients
We included preterm infants of gestational age less than 32 weeks, who were mechanically ventilated for respiratory distress syndrome, had echocardiographic evidence of hemodynamically significant PDA (left atrium/aortic root diameter ratio >1.4), 26 and had normal renal echographic appearance in the study. The presence of congenital malformations, intraventricular hemorrhage of grade 2 or higher according to the classification of Papile et al., 27 or platelet count less than 50,000/mm 3 were
Patients
Sixteen preterm infants were studied. Eight patients (five male and three female) of gestational age 28 weeks (range, 25 to 30), birth weight 820 gm (range, 600 to 1390), and postnatal age 29 hours (range, 5 to 120) were treated with indomethacin; eight infants of 29 weeks gestational age (range, 27 to 31), 855 gm birth weight (range, 620 to 1620), 24 hours postnatal age (range, 10 to 53), four males and four females, were treated with ibuprofen. No significant differences in gestational age,
Discussion
The results of our study support the hypothesis that pharmacologic closure of the ductus arteriosus with ibuprofen does not significantly reduce cerebral perfusion in contrast to indomethacin. Doppler sonographic results of our study agree with previous findings, 12, 13, 14, 15 indicating a reduction of CBF velocity after rapid indomethacin administration in preterm infants with PDA, ranging from 25% to 60% and lasting at least 120 minutes. The concordance of the results of a clinical 133 Xenon
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Reprint requests: Fabio Mosca, MD, Patologia Neonatale, Clinica “Mangiagalli,” via Commenda 12, 20122, Milano, Italy.
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