The Comparison of Efficiency of Oral Ibuprofen and Intravenous Indomethacin for Patent Ductus Arteriosus in Very Low Birth Weight Infants

Abstract

Objective: Intravenous indomethacin is the conventional treatment for closure of patent ductus arteriosus (PDA) in preterm infants. However, there are very few studies about oral ibuprofen in preterm infants with PDA. Therefore, this study was done to evaluate the efficacy and side effects of oral ibuprofen compared to intravenous indomethacin in very low birth weight (VLBW) infants. Methods: From March 2008 to August 2012, medical records of 103 infants with VLBW who had PDA in Inje University Ilsan Paik Hospital were reviewed retrospectively. The medical treatment was given to the 90 infants with hemodynamically significant PDA. Patients were divided into the intravenous indomethacin (IV indo) group (n=27) and the oral ibuprofen (per oral [PO] ibu) group (n=63). Demographic findings and factors associated with PDA were compared between these groups. Results: There were no significant differences in the mean gestational age, birth weight, and demographic findings between the two groups. The conditions such as respiratory distress syndrome and PDA size were not different before treatment. The rate of ductal closure was 100% in IV indo and 95% in PO ibu. 3 infants in only PO ibu needed surgical closure. Blood urea nitrogen and Creatinine levels did not increase significantly in PO ibu compared with IV indo, and there was no notable increase in necrotizing enterocolitis or oliguria incidence in this group either. There were no significant differences in the mortality and late complications. Conclusion: Oral ibuprofen is as efficacious as intravenous indomethacin with similar adverse effects.