| Ibuprofen versus continuous indomethacin in premature neonates with patent ductus arteriosus: is the difference in the mode of administration? | |
| | |
MedLine Citation:
|
PMID: 18458658 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Ibuprofen has been proposed as a preferential alternative to indomethacin in treating patent ductus arteriosus (PDA), because it is purported to have less renal, mesenteric, and cerebral vasoconstrictive effects. However, short and long-term safety concerns regarding ibuprofen remain. Continuous slow infusion of indomethacin also eliminates peripheral vasoconstriction and may thus offer similar benefits to ibuprofen without safety concerns. In this study, our objective was to show that treating a PDA with continuous indomethacin is similar to ibuprofen in its effect on urine output, renal function, and blood flow velocities in the renal, superior mesenteric, and anterior cerebral arteries. Sixty four prematures with PDA were randomly, prospectively assigned to either treatment. PDA closure rates were similar (74 versus 59%; p = 0.123). Nine indomethacin-treated babies (29%) versus twelve ibuprofen babies (38%) underwent repeated therapy (p = 0.656). Two indomethacin and four ibuprofen infants required surgical ligation (p = 0.672). Serum creatinine, oliguria, estimated glomerular filtration rate, and fractional excretion of sodium were similar in both groups, as were blood flow velocity parameters in the vessels studied. There were no differences in necrotizing enterocolitis, BPD, intraventricular hemorrhage, and/or retinopathy of prematurity. In conclusion, PDA treatment with either continuous indomethacin infusion or ibuprofen was equally devoid of adverse renal effects and/or peripheral vasoconstrictive effects. |
| | |
Authors:
|
Cathy Hammerman; Irena Shchors; Stefan Jacobson; Michael S Schimmel; Ruben Bromiker; Michael Kaplan; Amiram Nir |
Related Documents
:
|
7212328 - The renal effects of sodium nitroprusside in postoperative cardiac surgical patients. 94638 - Renal perfusion changes during treatment of essential hypertension: prazosin versus pro... 3005558 - Interaction of the renin-angiotensin system and the renal nerves in the regulation of r... 10952678 - Sphingosine-1-phosphate reduces rat renal and mesenteric blood flow in vivo in a pertus... 3560858 - Effect of pentobarbital or urethane on bile secretion and chemical composition of blood... 2977858 - Assessment of gastric blood flow with laser doppler flowmetry. |
Publication Detail:
|
Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Pediatric research Volume: 64 ISSN: 1530-0447 ISO Abbreviation: Pediatr. Res. Publication Date: 2008 Sep |
Date Detail:
|
Created Date: 2008-08-25 Completed Date: 2008-11-12 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0100714 Medline TA: Pediatr Res Country: United States |
Other Details:
|
Languages: eng Pagination: 291-7 Citation Subset: IM |
Affiliation:
|
Department of Neonatology, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91031 Israel. cathy@cc.huji.ac.il |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Blood Flow Velocity
/
physiology Cerebral Arteries / physiology Cyclooxygenase Inhibitors / administration & dosage*, pharmacology Ductus Arteriosus, Patent / drug therapy*, physiopathology Glomerular Filtration Rate / drug effects, physiology Humans Ibuprofen / administration & dosage*, pharmacology Indomethacin / administration & dosage*, pharmacology Infant, Newborn Infant, Premature* Infusions, Intravenous Kidney / blood supply, drug effects, physiology Mesenteric Artery, Superior / physiology Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Cyclooxygenase Inhibitors; 15687-27-1/Ibuprofen; 53-86-1/Indomethacin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Ambulatory arterial stiffness index is increased in hypertensive childhood disease.
Next Document: Sildenafil acutely reverses the hypoxic pulmonary vasoconstriction response of the newborn pig.