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The comparison of the cardiac function of indomethacin and ibuprofen during the treatment of symptomatic patent ductus arteriosus in very low birth weight infants by measurement of B-Type Natriuretic Peptide

Lee, Jang Hoon; Nam, Seong Woo; Park, Kyu Hee; Lee, Eun Hee; Choi, Byung Min; Park, Moon Sung; Hong, Young Sook
Department of Pediatrics & Adolescent Medicine
Background: Ibuprofen treatment of patent ductus arteriosus (PDA) has been shown to be as effective as indomethacin in small randomized controlled trials, with possibly fewer adverse effects. We have previously shown that B-type natriuretic peptide (BNP) assays may be a useful screening tool for the presence of a symptomatic patent ductus arteriosus (PDA) in premature infants. BNP assays has also been shown to be useful in monitoring of the treatment response to medical and surgical management for symptomatic PDA.

Objective: To compare the direct hemodynamic effect of indomethacin and ibuprofen treatment of PDA in very low birth weight infants (VLBWI) by measurement of B-Type Natriuretic Peptide.

Design/Methods: Forty six VLBWI with symptomatic PDA, subsequently treated with indomethacin or ibuprofen, were enrolled. Three doses of indomethacin and ibuprofen were administered every 24 hours. Plasma BNP was measured prior to administration of each dose and at 24 hours after last dose of both drugs.

Results: There was no difference between treatment groups in demographics. The rate of closure of DA without surgical ductal ligation was 73.9% (17/23) in the ibuprofen group and 60.9% (14/23) in the indomethacin group. Plasma BNP at each time points were shown in table.

Conclusions: The hemodynamic effect that was evaluated with BNP measurement, was not different between indomethacin and ibuprofen
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