There is a report that acetaminophen may have a role in pharmacological closure of PDA (Patent arterial duct) in preterm infants. The investigators conducted this open label non randomized and non control study to try to support that report.
In-uteri, the arterial duct connects between the aorta and the main pulmonary artery, thus bypassing the lungs. Since the high pulmonary pressure and the low systemic pressure, the shunt trough the arterial duct in that time is right to left. After birth, systemic pressure rises and pulmonary pressure declines. As oxygen saturation rises, and prostaglandin secretion, the arterial duct closes, usually. In preterm infants, the arterial duct may remain open after birth. At this tume the shunt would be left to right, that would cause pulmonary congestion, and systemic hypoperfusion. Ibuprofen is the treatment of choice for PDA in preterm infants. Yet, ibuprofen is not effective after two weeks of age. Moreover, there are situations that prevent treatment with ibuprofen, such as thrombocytopenia or renal failure. Surgical closure of arterial duct is an alternative treatment, if ibuprofen is contraindicated, or if it fails. Lastly, there was a report that acetaminophen may have a role in pharmacological closure of PDA in preterm infants. The investigators conducted this open label non randomized and non control study to try to support that report.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
19
Per gavage paracetamol 15 mg/kg every 6 hours, for up to 7 days.
Per Gavage ibuprofen 10mg/kg x 3/d for up to 5 days Gold standard per literature
Open surgery for closure of PDA
Neonatal intensive care unit, Hillel Yaffe medical center
Hadera, Israel
Closure of arterial duct - yes / No
Echo-cardiogram that will give exact answer to the question: "was the arterial duct closed"?
Time frame: 1 week
Need for surgical closure of arterial duct
The clinical state of the infant will guide the team to ask the parents and the chest surgeon to surgically close the arterial duct
Time frame: 1 week
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