Comparison of standard versus high-dose ibuprofen for the treatment of hemodynamically significant patent ductus arteriosus in preterm infants

Objective To evaluate the effectiveness and safety of standard vs. high-dose ibuprofen for the treatment of hemodynamically significant patent ductus arteriosus(hs-PDA). Study design A retrospective study of preterm infants who received either standard (10-5-5 mg/kg/day) or high (postnatal age 1-3 days: 10-5-5 mg/kg/day; 3-5 days: 15-7.5-7.5 mg/kg/day; >5 days: 20-10-10 mg/kg/day) dose ibuprofen for hs-PDA was conducted. Result Sixty preterm infants with a mean birthweight of 898.2 (+/- 262.6) g and mean gestational age of 26.3 (+/- 0.6) weeks were included. High-dose ibuprofen was associated with a 21%(95% CI, -1.87 to 39.06%; p = 0.07) absolute reduction in PDA ligation compared to standard-dose ibuprofen. On adjusted analysis, receipt of standard-dose ibuprofen (OR 7.37, 95% CI, 1.2-45.27; p = 0.03) independently predicted increased PDA ligation risk. There were no differences in oliguria, NEC, or BPD between groups. Conclusion High-dose ibuprofen may significantly reduce PDA ligations. No difference in the safety profile with high-dose ibuprofen as compared to the standard-dose regimen was demonstrated.

Automated summary

The study demonstrated that high-dose ibuprofen may significantly reduce the need for PDA ligations compared to standard dose ibuprofen when treating hemodynamically significant patent ductus arteriosus. The use of standard-dose ibuprofen may independently predict an increased risk of PDA ligation, but there were no differences in safety between the two doses.