PDA

[gmustafa]

Dear Respected Colleagues: Greetings. I would like to know your opinion about using “Ibuprofen as prophylaxis for PDA in preterm babies”. Thanks.

[Mo7]

Prophylaxis usually does not work !

what outcome you are looking for?

 

[Stefan Johansson]

Dear @gmustafa, there is a relatively recent Cochrane meta-analysis and their Conclusion is pretty negative, I paste part of it below. You find it here: https://pubmed.ncbi.nlm.nih.gov/31222841/

Quote

This review shows that prophylactic use of ibuprofen, compared to placebo or no intervention, probably decreases the incidence of patent ductus arteriosus, the need for rescue treatment with cyclo-oxygenase inhibitors, and for surgical ductal closure. Adverse effects associated with ibuprofen (IV or oral) included increased risks for oliguria, increase in serum creatinine levels, and increased risk of gastrointestinal haemorrhage. There was a reduced risk for intraventricular haemorrhage (grade III - IV) but no evidence of a difference in mortality, chronic lung disease, necrotising enterocolitis, or time to reach full feeds. In the control group, the patent ductus arteriosus had closed spontaneously by day 3 or 4 in 58% of neonates. Prophylactic treatment exposes a large proportion of infants unnecessarily to a drug that has important side effects without conferring any important short-term benefits. Current evidence does not support the use of ibuprofen for prevention of patent ductus arteriosus. Until long-term follow-up results of the trials included in this review have been published, no further trials of prophylactic ibuprofen are recommended.

 

[delhinn]

As far as i am aware there have been  studies on long term neurological outcome ( no significant benefit) in babies who received prophylactic ibuprofen . There was non significant decrease in incidence of severe IVH.