PDA and paracetamol

[Christian Heiring]

Dear all,

I would like to know if any units as of now have started to use paracetamol as a treatment for PDA in VLBW/ELBW.

There seem to be a few published studies looking at paracetamol as an alternative to indomethacine/ibuprofen and a few studies recruiting at the moment.

Personally I am not quite sure what to think, and just wanting to hear if there is any experience out there.

cheers

Christian

[selvanr4]

Ours is a small unit.i have used paracetamol for ductal closure in babies with low platelets. In one neonate with stage 1 a nnec. Used rectal route. We Were able to tide over the crisis .ductal closure achieved and features of ccf subsided.

[r.dippenaar]

We have been using intravenous Paracetamol for a few years now rather successfully on the recommendation of our resident paediatric cardiologist. The effects on a haemodynamically significant PDA appear to be equivocal but most noteworthy,  the nursing staff are particularly fond of it in the the extreme premies as subjectively it appears to them the patients are more peaceful and comfortable . I've attached an interesting article which is quietly reassuring. It would be nice to have pharmacokinetic and pharmacodynamic studies , hopefully in the future 

Paracetamol_PDA.pdf