Prophylaxis of Symptomatic Patent Ductus Arteriosus with Oral Ibuprofen in Very Low Birth Weight Infants
Chaisit Sangtawesin MD*, Varaporn Sangtawesin MD**, Watcharee Lertsutthiwong MD**, Wiboon Kanjanapattanakul MD**, Meera Khorana MD**, Jintakan Kasamesri Na Ayudhaya MD**
Affiliation : * Cardiology Unit, Department of Pediatrics, Queen Sirikit National Institute of Child Health, Department of Medical Services; MOPH, College of Medicine, Rangsit University, Bangkok ** Neonatal Unit, Department of Pediatrics, Queen Sirikit National Institute of Child Health, Department of Medical Services; MOPH, College of Medicine, Rangsit University, Bangkok
Background : Patent ductus arteriosus (PDA) is a common cause of mortality and morbidity among very low
birth weight infants. Oral ibuprofen suspension has been shown to have the same efficacy and safety as
intravenous indomethacin in the prevention and treatment of symptomatic PDA. With lower dosage, the
prevalence of side effects may decrease without changes in efficacy.
Objective : To evaluate the efficacy and side effects of low dose ibuprofen suspension for prevention of symp-
tomatic PDA in very low birth weight infants.
Patients and Method: A prospective, double blind, randomized controlled trial was conducted on premature
neonates with gestational ages between 28-32 weeks, birth weight 1500 grams or less, at the Neonatal Unit,
Queen Sirikit National Institute of Child Health (QSNICH) during October 2005 to October 2006. Only
infants who had PDA on echocardiogram were included in the study. Three doses of ibuprofen suspension or
placebo were randomly given at the dosage of 10, 5, 5 mg/kg every 24 hours. Daily physical examination,
serial laboratory evaluation and echocardiogram were used to evaluate symptomatic PDA, complications
and side effects.
Results : Sixty-two infants were recruited in the study and randomly assigned into the study and control group.
The gestational age and birthweight of the 2 groups were similar. The prevalence of symptomatic PDA was less
in the ibuprofen group than in placebo group (9.86% vs. 35.48%; p = 0.015). There were no differences in the
prevalence of complications and adverse effects between the two groups.
Conclusion : Prophylactic oral ibuprofen suspension at lower dosage results in less symptomatic PDA without
significant side-effects.
Keywords : Oral ibuprofen, Patent ductus arteriosus, Very low birth weight infants
