Document Detail


Echocardiography predicts closure of patent ductus arteriosus in response to ibuprofen in infants less than 28 week gestational age.
MedLine Citation:
PMID:  20663620     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patent ductus arteriosus (PDA) is a frequent problem in preterm infants, and its incidence is inversely correlated with gestational age. The efficacy of medical treatment decreases with decreasing gestational age (GA), and failure rates as well as ductus ligation rates of 40% have been reported in <28 week GA newborns. The aim of this study was to determine whether echocardiographic parameters can predict response to ibuprofen treatment of PDA.
STUDY DESIGN: In a longitudinal study, 29 infants born <28 week GA were screened for a significant PDA (left atrial to aortic root ratio>1.4, anterior cerebral artery resistance index>0.8, and oxygen requirement>35%) at 24-72 h of life and, if a PDA was found, treated with 10-5-5mg/kg ibuprofen intravenously every 24h. Ductal parameters were monitored by serial echocardiography. Infant neurodevelopmental outcomes were assessed at 24 month corrected age.
RESULTS: All 15 infants with significant PDA responded to the ibuprofen loading dose indicated by reduced PDA diameters or increased PDA maximum flow velocities (PDA V(max)), and 7 patients showed an ongoing response resulting in a closed PDA after the 1st cycle (47%). Of the 8 non-responders, 7 received a 2nd cycle with 2 further responders (29%). All non-responders to the 2nd course had a PDA V(max)<or=180 cm/s and increasing ductal diameters after the 3rd ibuprofen dose of the 1st course.
CONCLUSION: Maximum flow velocity and diameter of the PDA at the end of the 1st cycle discriminate between responders and non-responders to further ibuprofen treatment.
Authors:
Christiane Pees; Elisabeth Walch; Michael Obladen; Petra Koehne
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Early human development     Volume:  86     ISSN:  1872-6232     ISO Abbreviation:  Early Hum. Dev.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-23     Completed Date:  2010-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  503-8     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Neonatology, Charité, Universitätsmedizin Berlin, Berlin, Germany. chrpees@yahoo.de
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
Ductus Arteriosus, Patent / drug therapy*,  ultrasonography*
Echocardiography / methods
Female
Gestational Age
Humans
Ibuprofen / therapeutic use*
Infant, Newborn
Longitudinal Studies
Male
Prognosis
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 15687-27-1/Ibuprofen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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