Abstract
Introduction: Patent ductus arteriosus (PDA) is one of the most common cardiac problems in preterm neonates which could lead to morbidities, such as chronic lung disease, intraventricular hemorrhage and retinopathy. The aim of this study was to evaluate the effect of oral acetaminophen on closure of PDA in preterm neonates.
 Methods: Sixty-nine neonates with significant PDA (confirmed through echocardiography) were recruited in this study. Ibuprofen and indomethacin were contraindicated in these neonates These newborns were randomly divided into two groups of cases (n=36) and controls (n=33). The case group was treated with oral acetaminophen at a dose of 15 mg/kg/dose every 6 hours for 72 hours. The control group did not receive any intervention. After 72 hours, both groups were re-evaluated by echocardiography. In case of failed closure of PDA, the second course of treatment would be administration of acetaminophen. The main outcome of this study was to evaluate the rate of closure of PDA and the side effects of the acetaminophen.
 Results: The overall rate of PDA closure in the acetaminophen-receiving group was 94.4%; the ductus arteriosus was closed in 75% of patients with the first course of treatment. Moreover, 19.4% of patients did not respond to the first course of the treatment but their ductus arteriosus was closed with the second course of acetaminophen treatment. Of the patients, 5.6% did not respond to both courses of acetaminophen treatments. For the control group, the closure rate of PDA was 15.1%.
 Conclusion: The results of the study showed that oral acetaminophen is an effective alternative treatment for PDA in preterm neonates.
Highlights
Patent ductus arteriosus (PDA) is one of the most common cardiac problems in preterm neonates which could lead to morbidities, such as chronic lung disease, intraventricular hemorrhage and retinopathy
Ductus arteriosus is functionally closed within 24 hours after birth (Gournay, 2011); patent ductus arteriosus is a common problem among preterm newborns with respiratory distress syndrome (RDS)
This study was conducted on 75 preterm neonates with gestational age of 34 weeks or less who had the inclusion criteria and were admitted to the Neonatal Intensive Care Unit (NICU) of Imam Reza Hospital in Kermanshah, in Kermanshah City (Iran) during 2015
Summary
Patent ductus arteriosus (PDA) is one of the most common cardiac problems in preterm neonates which could lead to morbidities, such as chronic lung disease, intraventricular hemorrhage and retinopathy. The aim of this study was to evaluate the effect of oral acetaminophen on closure of PDA in preterm neonates. Results: The overall rate of PDA closure in the acetaminophen-receiving group was 94.4%; the ductus arteriosus was closed in 75% of patients with the first course of treatment. Conclusion: The results of the study showed that oral acetaminophen is an effective alternative treatment for PDA in preterm neonates. Patent ductus arteriosus (PDA) is one of the most common cardiac problems in premature infants The prevalence of this condition in neonates with gestational age less than 28 weeks is about 60-70% (Koch et al, 2006). Animal studies on monkeys have shown that there is an association between ibuprofen consumption and decrease in width of the nephrogenic zone in kidneys which may reduce nephrogenesis (Sutherland et al, 2012)
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