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Late medical therapy of patent ductus arteriosus using intravenous paracetamol
  1. Afif EL-Khuffash1,2,
  2. Adam T James1,
  3. Aoife Cleary1,
  4. Jana Semberova3,4,
  5. Orla Franklin5,
  6. Jan Miletin3,4,6
  1. 1Department of Neonatology, The Rotunda Hospital, Dublin, Ireland
  2. 2School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
  3. 3Coombe Women and Infants University Hospital, Dublin, Ireland
  4. 4Institute for the Care of Mother and Child, Prague, Czech Republic
  5. 5The Department of Paediatric Cardiology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland
  6. 6UCD School of Medicine and Medical Sciences, Dublin, Ireland
  1. Correspondence to Dr Afif EL-Khuffash, Department of Neonatology, The Rotunda Hospital, Parnell Street, Dublin 1, Ireland; afif_faisal{at}hotmail.com

Abstract

Objective To investigate the effect of late treatment with intravenous paracetamol on patent ductus arteriosus (PDA) closure prior to possible PDA ligation.

Methods A retrospective review of infants with a haemodynamically significant PDA, considered for PDA ligation and treated with intravenous paracetamol prior to possible ligation.

Results Thirty six infants with a median gestation of 26.1 weeks received paracetamol at a median age of 27 days. Paracetamol was associated with immediate closure in nine (25%) infants. There was no response to paracetamol treatment in four (11%) infants who subsequently underwent a PDA ligation. In 23 (64%) infants, the PDA constricted and all but one of this group demonstrated complete PDA closure prior to discharge.

Conclusions There may be a role for intravenous paracetamol in late closure of infants with a significant PDA to avoid ligation. The use of paracetamol for late treatment of PDA should be systematically evaluated.

  • Paracetamol
  • PDA
  • ligation
  • preterm infants
  • late treatment

https://doi.org/10.1136/archdischild-2014-307930

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