Treatment Of Patent Ductus Arteriosus Research Articles

Surgical treatment for patent ductus arteriosus in adult patients: a single center experience.

In contemporary practice, percutaneous closure of the patent ductus arteriosus (PDA) has become the procedure of choice. While the surgical ligation of ductus arteriosus ensures an immediate and definitive obliteration of the ductus, this therapeutic option is rarely used and reserved for situations when percutaneous solution is unsuitable. In this manuscript, we summarize the clinical and intraoperative findings of consecutive adult patients referred to our Institution in an interval of 10 years for surgical treatment of PDA. A total of five cases of surgical closure for PDA were performed in our Center. Four subjects were not suitable for percutaneous closure, and one was discovered intraoperatively, during surgery for another cardiac condition. In all patients, the closure of the PDA was carried out by means of a suture with reinforced patch threads, in a double layer. The intervention was performed in total cardiopulmonary bypass and mild or moderate hypothermia, through a transpulmonary approach. Total circulatory arrest was not required, in any of the cases. The occlusive balloon technique was applied to all patients. All patients survived the intervention and did not suffer perioperative complications. Postoperative follow-up at 36 months did not show repermeabilization of the arterial duct or aneurysmal dilation of the adjacent aorta. Moreover, all patients showed postoperative improvement in the performance of the left ventricle. In adult patients with PDA and contraindication to percutaneous closure or in those who require surgical sanction for other cardiac diseases, surgical closure of the duct is safe and associated with favorable clinical evolution.

Survey on human milk feeding and enteral feeding practices for very-low-birth-weight infants in NICUs in China Neonatal Network

BackgroundThe breastfeeding rate in China is lower than that in many other countries and the extent of adoption of the “Feeding Recommendations for Preterm Infants and Low Birth Weight Infants” guideline in NICUs remains unclear.MethodA web-based survey about the current status of human milk feeding and enteral feeding practices at NICUs was sent to all China Neonatal Network’s cooperation units on September 7, 2021, and the respondents were given a month to send their responses.ResultsAll sixty NICUs responded to the survey, the reply rate was 100%. All units encouraged breastfeeding and provided regular breastfeeding education. Thirty-six units (60.0%) had a dedicated breastfeeding/pumping room, 55 (91.7%) provided kangaroo care, 20 (33.3%) had family rooms, and 33 (55.0%) routinely provided family integrated care. Twenty hospitals (33.3%) had their own human milk banks, and only 13 (21.7%) used donor human milk. Eight units (13.3%) did not have written standard nutrition management guidelines for infants with body weight < 1500 g. Most units initiated minimal enteral nutrition with mother’s milk for infants with birth weight ˂1500 g within 24 h after birth. Fifty NICUs (83.3%) increased the volume of enteral feeding at 10–20 ml/kg daily. Thirty-one NICUs (51.7%) assessed gastric residual content before every feeding session. Forty-one NICUs (68.3%) did not change the course of enteral nutrition management during drug treatment for patent ductus arteriosus, and 29 NICUs (48.3%) instated NPO for 1 or 2 feeds during blood transfusion.ConclusionThere were significant differences in human milk feeding and enteral feeding strategies between the NICUs in CHNN, but also similarities. The data obtained would be useful in the establishment of national enteral feeding guidelines for preterm infants and quality improvement of cooperation at the national level.

Transcatheter Closure of Patent Ductus Arteriosus in infants between 2-10 kg

Objective: The aim of this study was to present our experiences on transcatheter patent ductus arteriosus (PDA) closure with different devices, mostly the Amplatzer Piccolo Occluder, in infants weighing between 2-10 kg. Material and Methods: In this study, the files of 31 patients who underwent transcatheter PDA closure between December 2019 and August 2022 were reviewed retrospectively. Results: Transcatheter PDA closure was performed on 31(14 female) infants weighing between 2-10 kg. The mean age of patients was 10.7±6.7 months (2-28), and the mean weight was 6.6±2 kg (3-9.9). The median narrowest diameter of the ductus was 2.2 mm (IQR 2-3) and the median ductus length was 6 mm (IQR 4.75-8). The procedural success rate of all interventional procedures was 88% (30 of 34). Complications occurred in a total of four patients including failure of device implantation in one patient, post-procedural device embolization in 2 patients, and the significant residual shunt in one patient. None of the patients required surgery. In 34 interventional procedures, 3 of which were reintervention, 34 devices were used. Twenty-seven (79%) of them were Amplatzer Piccolo Occluder. The median fluoroscopy and procedural times were 10.5 minutes (IQR 7.25-18.5) and 40 minutes (IQR 35-57.5) respectively. The mean duration of follow-up was 10.3±8.8 months (1-32 months). Conclusion: In our experience, transcatheter treatment of PDA with the Amplatzer Piccolo Occluder device which was our first choice for appropriate duct anatomy and size in infants weighing between 2-10 kg, is safe and effective.

Application of robot-assisted endoscopic technique in the treatment of patent ductus arteriosus in 106 children

The objective is to evaluate and apply the robot-assisted endoscopic surgical technique for treatment of patent ductus arteriosus (PDA) in children. Clinical data of 106 children with PDA who underwent robot-assisted endoscopic operation were retrospectively analyzed from August, 2020 to March, 2022. Demographic and preoperative data were collected, including the patient’s age, weight, diameter of the ductus arteriosus, operation time, length of postoperative hospital stay, postoperative complications and hospitalization cost. The age ranged from 6 months to 12 years with median age of 2.5 years. In addition, the weight ranged from 6.6 kg (kg) to 51.6 kg with median weight of 12.5 kg. Patients who received transcatheter PDA closure were also enrolled during the same period. Clinical features and perioperative data were compared between the two groups. All the 106 cases underwent robotically assisted surgery for PDA ligation. No one was converted to thoracotomy. The length of operation time was 15–84 min, with an average of 39.4 min. There was no obvious bleeding during the operation. The length of postoperative hospital stays were 1–3 days, with an average of 1.1 ± 0.2 days, which was significantly shorter than that of patients underwent transcatheter approach PDA closure (2.2 ± 0.2 days) (p < 0.05). The average hospitalization costs were US$ 8180 in the 106 patients, which were more expensive than that of ones who received transcatheter procedure (US$ 5076 ± 406) (p < 0.05). Only one case was found to have residual ductus shunt during early postoperative follow-up. One case was found with recurrent laryngeal nerve injury. The two cases recovered after 3 months of follow-up. The median duration of follow-up was 12 (1–20) months. No other short-term complications occurred during the follow-up period. Robotic surgical technique for PDA ligation in children is a safe, effective and reliable surgical method with less trauma, faster recovery and fewer surgical risks. This approach should be considered as an option in children patients requiring PDA ligation.

Comparison of Therapeutic Effect and Safety of Oral and Rectal Use of Acetaminophen on Patent Ductus Arteriosus in Preterm Infants: Clinical Randomized Trial.

The prevalence of patent ductus arteriosus (PDA) in preterm infants is high. There is little information about the therapeutic effect and safety of rectal acetaminophen in the treatment of PDA. We aimed to compare the therapeutic effect and safety of oral and rectal acetaminophen on PDA in preterm infants. This study was a single-blind randomized clinical trial using 40 preterm infants. The cases were hospitalized in the neonatal intensive care unit of Mohammad Kermanshahi and Imam Reza hospitals of Kermanshah. Subjects were randomly divided into 2 groups, the first group was treated with oral acetaminophen and the second group was treated with rectal acetaminophen. The presence of PDA and response to treatment was assessed based on pre- and post-treatment echocardiographic criteria. The likelihood of complications or prohibition of acetaminophen use was assessed with paraclinical tests before and after treatment. The neonates were in the age range of 30 to 35 weeks. Twenty-one cases (52.5%) were boys and 19 cases (47.5%) were girls. Two cases in the oral-acetaminophen group and 1 case in the rectal-acetaminophen group needed the second round of treatment. There was no difference between the success of treatment and the type of treatment. The study showed that there was no difference between PDA treatment of preterm infants with oral and rectal acetaminophen. Also, no side effects were observed in treatment with any of the treatments. Therefore, it could be suggested that in infants who are intolerant to oral acetaminophen, the rectal form can be used.

The effects of intravenous paracetamol use on blood parameters in the treatment of patent ductus arteriosus

Aim: Patent ductus arteriosus (PDA), a cause of significant hemodynamic imbalance in newborn babies, can be treated using pharmacological or surgical methods. The purpose of this study was to compare intravenous (IV) paracetamol in newborns with hemodynamically significant PDA, with indomethacin and ibuprofen in terms of changes caused in blood parameters.Methods: Intravenous paracetamol was used for 3-6 days at 4x15 mg/kg/dose in cases diagnosed with PDA and admitted for follow-up between November 2014 and December 2015, and unable to receive oral medication or with contraindications for indomethacin-ibuprofen use. These cases were investigated retrospectively in terms of changes in pre and post-treatment AST (aspartate aminotransferase), ALT (alanine aminotransferase), urea, creatinine, platelet, and neutrophil values.Results: Intravenous paracetamol was administered to 10 cases of PDA, diagnosed between November 2014 and December 2015. Prior to paracetamol therapy, an increase in urea values was present in one case, increased AST in two, and decreased platelet values in two. Post-treatment values returned to normal ranges in all cases, and hemodynamic improvement was observed after the closure of the ductus arteriosus.Conclusion: Our analysis of its effect on PDA closure and its potential side-effect profile in patient blood parameters compared to other known therapeutic agents indicates that intravenous paracetamol, which is easily available and accessible in Turkey, may be an important option for the treatment of PDA.

Follow up and outcome of transcatheter device closure in pediatric patients in a tertiary cardiac centre of Nepal

BackgroundCongenital heart diseases have significant effect on the growth and development of a child. Timely intervention helps a child to grow and develop to full potential. Cardiac interventionists have not long ago developed methods to cure conditions via transcatheter methods like device closures for shunt lesions. These interventions have been hugely accepted and applied all over the world. ObjectivesThe aim of this study was to determine the outcome of Transcatheter device closure in Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD) and Patent Ductus Arteriosus (PDA) in terms of improvement in echocardiographic parameters and nutritional well-being. It also outlined the immediate and long term complications of Transcatheter device closure of the shunt lesions. MethodologyA prospective study was carried out among 129 pediatric patients who underwent Transcatheter device closure of shunt lesions at Shahid Gangalal National Heart Centre from March 2019 to March 2021. Simple convenient, consecutive non-probability sampling method was used for the study.Independent sample t-test was applied to see the correlation and significance of continuous variables and Linear regression was used to find out relation between weight gain and device closure. ResultsAmong 129 pediatric patients having either ASD, PDA or VSD without other comorbidities who underwent transcatheter device closure at Shahid Gangalal National Heart Centre, there was 1 mortality (0.7 %), 3 device embolization (2.3 %), 11 (8.5 %) tiny residual leaks, 6 (4.6 %) femoral artery thrombosis, 19 (14.7 %) Left ventricular systolic dysfunction, 4 (3.1 %) new onset arrhythmia, 13(10.0 %) new onset trivial AR and 2 (1.5 %) mild obstruction to surrounding structures. There were no long term complications observed during the study period. Pulmonary artery pressures improved in most along with normalization of chamber dilatation. There was significant improvement in weight of children at the end of one year follow up (P < 0.001), however among individual shunt lesion, only patients undergoing PDA device closure demonstrated significant weight gain. ConclusionTranscatheter device closure is a promising, safe and effective means of treatment for ASD, PDA and VSD. It has significant bearing in weight gain as well as general well-being of children. Judicious selection of cases, proficient expertise and availability of suitable infrastructures are paramount for successful outcome.

Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low birth weight infants.

Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low birth weight infants.

Fluid restriction for treatment of symptomatic patent ductus arteriosus in preterm infants

Fluid restriction for treatment of symptomatic patent ductus arteriosus in preterm infants

Plasma Chymase Activity Reflects the Change in Hemodynamics Observed after the Surgical Treatment of Patent Ductus Arteriosus in Dogs.

Chymase is a protease stored in mast cell granules that produces angiotensin II (ANG II) from angiotensin I (ANG I) and is associated with tissue injury, inflammation, and remodeling, especially involving the cardiovascular system. As cardiovascular events occur, chymase is activated by degranulation to the extracellular matrix. Although chymase has been suggested to be associated with cardiovascular disease progression, there are not enough reports in veterinary medicine. Patent ductus arteriosus (PDA) is a common congenital cardiac disease in veterinary medicine. Almost all cases of PDA can be treated surgically to prevent the development of congestive heart disease and/or pulmonary hypertension. The aims of the present study were to measure chymase activity before and after PDA occlusions, and to investigate the relationships between the congestive and hemodynamic states of PDA and chymase activity. In the present study, 17 puppies diagnosed with PDA were included and all puppies completely recovered to the level of healthy dogs. Chymase activity significantly decreased at 2 months after the operation, along with the echocardiography parameters of congestion. Therefore, plasma chymase activity may be useful as a novel predictor for understanding the hemodynamics of PDA in veterinary medicine.

Fluid restriction in management of patent ductus arteriosus in Italy: a nationwide survey.

Our survey shows an extreme variability among centers in terms of use of fluid restriction as a prophylactic tool but also in terms of its use (both opportunity and modality) when a hemodynamically significant PDA is diagnosed. This variability, that can be also found in randomized trials and observational studies, suggests that further evidence is needed to better understand its potential beneficial effects and its potential harms such as dehydration, hypotension, decreased end-organ perfusion, and reduced caloric intake. • The lack of demonstrable improvement following the treatment of patent ductus arteriosus has recently paved the way to a more conservative approach. • Fluid restriction is the most commonly applied conservative treatment of PDA. • Among Italian NICUs an extreme variability in terms of indications, timing and modalities of application of Fluid restriction can be found. • This variability reflects the lack of standardization of this practice and the contrasting evidence on its efficacy.

Use of paracetamol for the treatment of patent ductus arteriosus in premature Newborns: A systematic review

Objective: Patent ductus arteriosus is associated with multiple complications and high neonatal mortality. This study aimed to evaluate the efficacy and benefits of paracetamol compared to ibuprofen and indomethacin, non-steroidal anti-inflammatory drugs usually used to close the ductus arteriosus in premature newborns. Data source: We searched the PubMed, SciELO, Lilacs, Bireme, ClinicalTrials.gov and Embase databases for articles published between January 2005 and December 2020. The descriptors used were: premature newborn, patent ductus arteriosus, pharmacotherapy, closure and paracetamol / acetaminophen. The quality of the articles was evaluated by the classification of the Oxford Centre for Evidence based Medicine. Data synthesis: The efficacy of paracetamol is comparable to that of ibuprofen and indomethacin, and it is associated with lower rates of gastrointestinal and intracerebral hemorrhage, spontaneous intestinal perforation, thrombocytopenia, hepatic and renal intolerance, and lower serum values of urea, creatinine, and bilirubin. Furthermore, it is more advantageous than placebo or nonintervention and may be the best option in cases with contraindications for other drugs. Gestational age and birth weight were factors that influenced the efficacy of paracetamol and showed reduced efficacy in extremely premature newborns with extremely low and very low birth weights. Conclusions: Other clinical and prospective studies are needed to support the indication of paracetamol in patent ductus arteriosus. However, this drug proves to be a promising pharmacological alternative, having similar efficacy to classic non-steroidal anti-inflammatory drugs, with fewer adverse effects.

Differential effects of ibuprofen and indomethacin on cerebral oxygen kinetics in the very preterm baby.

BackgroundIbuprofen is preferred to indomethacin for treatment of a significant patent ductus arteriosus (PDA) in preterm babies despite indomethacin being associated with a lower risk of intraventricular haemorrhage. This difference is thought to relate to the discrepant effects of each medication on cerebral oxygen kinetics yet the effect of ibuprofen on cerebral perfusion is uncertain.MethodsForty-eight babies < 30 weeks with a significant PDA, defined by echocardiography, were randomly assigned to either indomethacin or ibuprofen (n = 24 per group) and stratified by gestation and chronologic age. Cerebral blood flow [total internal carotid blood flow (TICF)] and oxygen physiology [oxygen delivery (modCerbDO2) and consumption (modCerbVO2)] were measured using cranial Doppler ultrasound and near-infrared spectroscopy, and cerebral oxygen extraction (cFTOE) calculated, immediately before and following administration. Temporal and treatment related changes were analysed.ResultsA fixed effect of time was seen for TICF (p = 0.03) and therefore modCerbDO2 (p = 0.046) and cFTOE (p = 0.04) for indomethacin alone. In the indomethacin group, TICF and modCerbDO2 fell from baseline to 5 and 30 min respectively (TICF p < 0.01, cDO2 p = 0.01) before increasing from 5 min to 24 h (p < 0.01) and 30 min and 24 h (p < 0.01) timepoints. cFTOE peaked at 30 min (p = 0.02) returning to baseline at 24 h. There was a parallel increase in arterial lactate.ConclusionIndomethacin significantly reduces cerebral blood flow soon after administration, resulting in a parallel increase in oxygen extraction and arterial lactate. This implies that the balance of oxygen kinetics at the time of treatment may be critical in very preterm babies with significant PDA.

Hospital variation in neonatal echocardiography among very preterm infants at US children's hospitals.

Estimate hospital variation in echocardiography (echo) among very preterm infants. Retrospective cohort study of very preterm (<32 weeks) infants discharged between 2012 and 2019 from US children's hospitals. Echo exposure was identified using daily billing, and hospital variation was estimated after adjustment for illness severity. Variation in very early echo use (<3 days of life) was compared to exposure to treatment of a patent ductus arteriosus (PDA), and other practice patterns. 27,498 subjects across 39 children's hospitals were included. Very early echo use had the greatest hospital variation (3-34%). Increasing very early echo use was not associated with PDA treatment (p = 0.93), but was associated with nitric oxide (p < 0.01) and vasoactive medications (p < 0.01). Hospital variation in echo use among preterm infants was greatest in the first few days of life and was associated with increasing nitric oxide and vasoactive medication use. The impact of this variation on clinical outcomes is uncertain and warrants further investigation.

Breastfeeding impact on patent ductus arteriosus closure in preterm newborns

Background. Patent ductus arteriosus (PDA) is a serious problem in clinical neonatology and pediatrics. Today treatment of PDA remains debatable because of high risk of complications with medical and invasive treatment. The purpose of the study was to determine the dependence of PDA closure on the type of feeding the newborn. Materials and methods. We have made a retrospective analysis of 300 case histories of children in neonatal units. We selected two comparison groups: the main group consisted of breastfed babies born at 37 weeks gestation (n = 102); controls — preterm infants who received artificial feeding since birth (n = 198). Results. At discharge from the hospital, 44 (14.7 ± 2.0 %) children had PDA (p &lt; 0.05). The percentage of infants on artificial feeding with PDA was 2.3 times higher compared to breastfed babies: 18.2 ± 2.7 % versus 7.8 ± 2.7 % (p = 0.017 by χ2 test). Respiratory distress syndrome was more common in the control group as well: 72.7 ± 3.2 % versus 46.1 ± 4.9 % (p &lt; 0.001). Additionally, the group of formula-fed children more often had severe complications of respiratory distress syndrome: respiratory failure type III — 25.8 ± 3.1 % versus12.7 ± 3.3 % (р = 0.009); development of bronchopulmonary dysplasia — 13.1 ± 2.4 % versus 2.9 ± 1.7 % (p = 0.005). The need for invasive mechanical ventilation in the intensive care unit was observed much less often in breastfed children. Moreover, the level of respiratory disorders (type II respiratory failure) in both groups differed insignificantly (p = 0.742): 24.5 ± 4.3 % in the main group and 26.3 ± 3.1 % in controls. Conclusions. Breastfeeding from the first days of life contributes to the closure of the ductus arteriosus and the favorable course of respiratory distress syndrome in premature babies.

Patent Ductus Arteriosus: A Contemporary Perspective for the Pediatric and Adult Cardiac Care Provider.

The burden of patent ductus arteriosus (PDA) continues to be significant. In view of marked differences in preterm infants versus more mature, term counterparts (viewed on a continuum with adolescent and adult patients), mechanisms regulating ductal patency, genetic contributions, clinical consequences, and diagnostic and treatment thresholds are discussed separately, when appropriate. Among both preterm infants and older children and adults, a range of hemodynamic profiles highlighting the markedly variable consequences of the PDA are provided. In most contemporary settings, transcatheter closure is preferable over surgical ligation, but data on longer‐term outcomes, particularly among preterm infants, are lacking. The present review provides recommendations to identify gaps in PDA diagnosis, management, and treatment on which subsequent research can be developed. Ultimately, the combination of refined diagnostic thresholds and expanded treatment options provides the best opportunities to address the burden of PDA. Although fundamental gaps remain unanswered, the present review provides pediatric and adult cardiac care providers with a contemporary framework in PDA care to support the practice of evidence‐based medicine.

Effect of fetal lung maturation on the treatment of patent ductus arteriosus in premature infants.

Effect of fetal lung maturation on the treatment of patent ductus arteriosus in premature infants.

Clinical and echocardiographic characteristics associated with evolution of patent ductus arteriosus in preterm neonates: A prospective cohort study

In preterm infants, persistence of ductus arteriosus is an important medical condition. Functional echocardiography for patent ductus arteriosus (PDA) may guide clinical decision-making regarding treatment requirement strategies. Objectives of the study were to assess the trends of clinical and functional echocardiographic parameters with evolution of ductus arteriosus in babies≤1250 gm of birth weight and to evaluate whether there is any association of these parameters with persistence of ductus. In this prospective observational study, recruited babies were assessed serially for clinical events and functional echocardiography. Babies were classified into three groups: without PDA, with PDA but PDA spontaneously closed (within 7 days) and persistent PDA. We included 143 infants (Birth weight 1017±179 g, gestational age 30.8±2.7 weeks). Out of 60 babies with PDA, PDA failed to close spontaneously in first week in 32 (53.4 %) infants. PDA Doppler flow pattern on day 3 was found to be one of the most significant markers for future ductus. The highest frequency of growing pattern (37.5%) and pulsatile pattern (59.4%) was seen in persistence ductus group. PDA diameter and LA/Ao ratio were found strongly correlated with all other variables except E/A ratio. We noticed persistence of ductus in preterm infants had significant clinical and echocardiographic association. PDA doppler flow pattern on day 3 was found to be a significant marker for future behaviour of ductus. Significant correlation was found among individual functional echocardiographic parameters in babies with PDA. This would guide judicious treatment of PDA in preterm neonates.

Efficacy and safety of high versus standard dose ibuprofen for patent ductus arteriosus treatment in preterm infants: A systematic review and meta-analysis.

Several small randomized controlled trials (RCTs) and observational studies have compared high (15-20/7.5-10/7.5-10 mg/kg/dose) versus standard dose (10/5/5 mg/kg/dose) ibuprofen for patent ductus arteriosus (PDA) closure, with limited evidence on efficacy and safety. To systematically review and meta-analyze studies of high versus standard dose ibuprofen for the closure of PDA in preterm infants. Databases were searched for RCTs and observational studies assessing high compared to standard dose of ibuprofen for PDA closure for preterm infants until August 2021. The primary outcome was failure of PDA closure after the first course of ibuprofen. The secondary outcomes were the failure of PDA closure after a second course of ibuprofen, rates of PDA ligation, all-cause mortality prior to hospital discharge, bronchopulmonary dysplasia, necrotizing enterocolitis, bleeding disorders, oliguria, and serum creatinine after treatment. There were 6 studies with 369 patients (3 RCT, N = 190; 3 observational studies, N = 179). Compared to standard dose, high dose ibuprofen did not significantly decrease the failure rate of PDA closure in preterm infants after the first course (Relative risk (RR) 0.74, 95% confidence interval (CI) 0.53 -1.03, 6 studies, N = 369). High dose ibuprofen significantly decreased the rates of PDA ligation compared to standard dose (RR 0.33, 95% CI 0.16 -0.70, 5 studies, N = 309). Based on low-grade evidence, high dose ibuprofen may more effectively reduce rates of PDA ligation compared to standard dose with no increase in adverse effects, neonatal morbidities and mortality.

Increased Total Serum Bilirubin Level Post-Ibuprofen Use Is Inversely Correlated with Neonates' Body Weight.

Backgrounds: Drugs with the ability to displace bilirubin from albumin-binding sites subsequently leading to an increased bilirubin level may cause hyperbilirubinemia in neonates. Ibuprofen is commonly used to treat patent ductus arteriosus (PDA) in neonates, yet the use of ibuprofen has drawn mixed conclusions. We performed a retrospective study to determine how ibuprofen use influences the total serum bilirubin (TSB) level in neonates of differing birth weight (BW). Materials and methods: Neonates (including premature infants) born at Chang Gung Memorial Hospital, Taiwan during January 2004 to July 2020 were entered into this study. We recorded the phototherapy duration, including the initial day and end day, and determined the average influence of one-day phototherapy on TSB level. The highest monitored TSB level post-ibuprofen use minus the one measured prior to ibuprofen use was considered the TSB change following ibuprofen administration in this study, and the above-mentioned influence of daily phototherapy on the TSB level was used to correlate the results. Neonates with any of the following conditions were excluded: those who received ceftriaxone, those with intraventricular hemorrhage, and those infected with TORCH. Results: The average daily influence of phototherapy on the TSB level of neonates was −0.20 (−0.57~0.05) mg/dL, −0.28 (−0.84~0.13) mg/dL, −0.75 (−1.77~0.10) mg/dL, and −1.60 (−2.70~−0.50) mg/dL in neonates with BWs of <1 kg, 1–1.49 kg, 1.5–2.49 kg, and ≥2.5 kg, respectively, indicating that neonates with a BW ≥ 1.5 kg experienced a greater reduction in TSB level following phototherapy as compared with those with a BW < 1.5 kg. The average TSB increase following ibuprofen use in neonates was 3.38 ± 2.77 mg/dL, 2.04 ± 2.53 mg/dL, and 1.34 ± 2.24 mg/dL in neonates with BWs of <1 kg, 1–1.49 kg, and ≥1.5 kg, respectively, i.e., an elevated TSB change with a decreased neonate BW was noted post-ibuprofen use (p = 0.026, one-way analysis of variance (ANOVA)). Conclusions: As ibuprofen use is correlated with an apparent increase in TSB level in neonates with a lower BW, especially in those with a BW < 1 kg, iv acetaminophen can be an appropriate alternative to ibuprofen for ELBW neonates for the treatment of PDA if they are experiencing severe unconjugated hyperbilirubinemia.