Echocardiographic comparison between oral acetaminophen versus ibuprofen in management of patent ductus arteriosus in neonates

Abstract

BackgroundPatent ductus arteriosus (PDA) is a common complication in preterm neonates with the incidence of 30–67% in extremely preterm neonates, which results in increased pulmonary blood flow and increased incidence of further comorbidities such as chronic lung disease.ObjectiveTo evaluate the effect of oral acetaminophen versus ibuprofen in the management of PDA in premature infants by echocardiography.Patients and methodThe study was carried out on 50 preterm neonates diagnosed by echocardiography to have PDA in the neonatal intensive care unit in Menoufia University Hospital from March 2019 to September 2019. Patients were classified into two groups: group 1 included neonates who received oral acetaminophen at a dose of 15 mg/kg every 6 h for 3 days and group 2 included neonates who received oral ibuprofen at the initial dose of 20 mg/kg followed by 10 mg/kg for 3 days. Both acetaminophen and ibuprofen were administrated via an orogastric tube, which was flushed with 1–2 ml of sterile water to ensure delivery of the drug. Both groups were evaluated by echocardiography. All patients were subjected to complete history taking, thorough clinical examination, complete blood count, and kidney and liver function tests.ResultsAfter the first course of treatment, PDA closed in 21 (84%) patients who received oral acetaminophen versus 21 (84%) of those given oral ibuprofen (P = 0.766). After the second course of treatment, PDA closed in 12% of oral acetaminophen group and 8% of oral ibuprofen group.ConclusionThere was no significant difference between the treatment of PDA with either oral acetaminophen or oral ibuprofen in preterm neonates, but acetaminophen has minimal adverse effects.