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Paracetamol and preterm

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https://www.readbyqxmd.com/read/29695206/efficacy-and-safety-of-oral-paracetamol-versus-oral-ibuprofen-for-closure-of-patent-ductus-arteriosus-in-preterm-infants-a-randomized-controlled-trial
#1
Rania A El-Farrash, Mohammed S El Shimy, Abeer S El-Sakka, Manal G Ahmed, Dina G Abdel-Moez
OBJECTIVE: To evaluate the efficacy and safety of oral paracetamol versus oral ibuprofen in the treatment of hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. STUDY DESIGN: An interventional randomized case-control study, registered in ClinicalTrials.gov ( NCT03265782 ), was conducted on 60 preterm infants with gestational age ≤ 34 weeks, postnatal age of 2-7 days and color Doppler echocardiographic evidence of hsPDA. Neonates were randomly assigned to two groups; 30 received oral ibuprofen and 30 received oral paracetamol...
April 25, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29624206/paracetamol-acetaminophen-for-patent-ductus-arteriosus-in-preterm-or-low-birth-weight-infants
#2
REVIEW
Arne Ohlsson, Prakeshkumar S Shah
BACKGROUND: In preterm newborns, the ductus arteriosus frequently fails to close and the infants require medical or surgical closure of the patent ductus arteriosus (PDA). A PDA can be treated surgically; or medically with one of two prostaglandin inhibitors, indomethacin or ibuprofen. Case reports suggest that paracetamol may be an alternative for the closure of a PDA. An association between prenatal or postnatal exposure to paracetamol and later development of autism or autism spectrum disorder has been reported...
April 6, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29492399/efficacy-of-paracetamol-in-closure-of-ductus-arteriosus-in-infants-under-32-weeks-of-gestation
#3
Ines Tofe, Maria Dolores Ruiz-González, Maria Dolores Cañete, Asuncion Pino, Rosa Lorena Rueda, Maria Jose Parraga, Juan Luis Perez-Navero
Background: Standard medical treatment for patent ductus arteriosus (PDA) closure has been indomethacin/ibuprofen or surgical ligation. Up to date, new strategies have been reported with paracetamol. The aim of this study was to present our experience with intravenous paracetamol for closing PDA in preterm neonates presenting contraindication to ibuprofen or ibuprofen had failed and no candidates for surgical ligation because of huge instability. Materials and methods: We conducted a retrospective case series study in a neonatal intensive care unit from a tertiary hospital...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29372379/effect-on-cerebral-oxygenation-of-paracetamol-for-patent-ductus-arteriosus-in-preterm-infants
#4
Carlo Dani, Chiara Poggi, Ilaria Cianchi, Iuri Corsini, Venturella Vangi, Simone Pratesi
Paracetamol seems to have similar success rates compared with indomethacin and ibuprofen in closing patent ductus arteriosus (PDA) in preterm infants, but with a better safety profile. The aim of our study was to evaluate the possible effects of paracetamol on cerebral oxygenation and cerebral blood flow velocity (CBFV). Infants with gestational age < 32 weeks with hemodynamically significant PDA (hsPDA) were prospectively studied by near infrared spectroscopy (NIRS) after the first dose of paracetamol (15 mg/kg) or ibuprofen (10 mg/kg)...
April 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29276647/low-dose-intravenous-paracetamol-for-patent-ductus-arteriosus-in-indomethacin-resistant-or-contraindicated-preterm-infants-three-cases-reports
#5
Shun Matsumura, Ayumi Oshima, Sumie Fujinuma, Kosuke Tanaka, Nobuhiko Nagano, Fuyu Miyake, Satoshi Masutani, Masanori Tamura, Keiko Ueda, Fumihiko Namba
Background  Although indomethacin (IND) is the standard treatment for hemodynamically significant patent ductus arteriosus (hsPDA) in Japan, it may be associated with renal impairment and gastrointestinal complications. The use of paracetamol for hsPDA closure has recently increased. Unlike IND, paracetamol does not have a peripheral vasoconstrictive effect and can be given to infants with contraindications to IND. Based on limited data available from randomized trials, paracetamol and IND seem to have similar effects...
October 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29105147/intravenous-paracetamol-was-associated-with-closure-of-the-ductus-arteriosus-in-extremely-premature-infants
#6
S Juujärvi, T Saarela, M Hallman, O Aikio
AIM: Symptomatic patent ductus arteriosus may lead to serious complications in extremely preterm and extremely low birthweight infants and is often resistant to medication. We evaluated early intravenous paracetamol for pain prevention during respiratory therapy, in an attempt to understand the ductal treatment of such infants. METHODS: Our cohort were 295 extremely preterm or extremely low birthweight infants, born at less than 28 weeks or 1000 g, respectively, who were treated in the neonatal intensive care unit of Oulu University Hospital from 2002 to 2015, before and after intravenous paracetamol was introduced in June 2009...
April 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29079904/neonatal-gastric-perforations-in-very-low-birth-weight-infants-a-single-center-experience-and-review-of-the-literature
#7
Aslan Babayigit, Seyithan Ozaydın, Merih Cetinkaya, Serdar Sander
PURPOSE: Gastric perforation is a rare condition with high mortality rates in preterm infants. The aim of this retrospective study was to define the risk factors and prognosis in very low birth weight (VLBW) infants with gastric perforations. METHODS: VLBW infants with a diagnosis of gastric perforation between 2012 and 2016 were included. The data including birth weight, gestational age, gender, risk factors, time and location of the perforation and prognosis were recorded...
January 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/28933266/intravenous-paracetamol-dosing-guidelines-for-pain-management-in-pre-term-neonates-using-the-paediatric-study-decision-tree
#8
P Mian, C A J Knibbe, E A M Calvier, D Tibboel, K Allegaert
BACKGROUND: Intravenous paracetamol (acetaminophen) has not been licensed for analgesia in preterm neonates or infants < 2 years, respectively, in Europe and the United States. A variety of dosing regimens is therefore used off-label. Because evidence supports the use of the same target mean steady state paracetamol concentration (Cssmean, 9-11 mg/L) for pain relief in neonates compared to older children and adults, dosing regimens based on this Cssmean were evaluated in a two-step approach...
2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28828381/paracetamol-in-patent-ductus-arteriosus-treatment-efficacious-and-safe
#9
REVIEW
Flaminia Bardanzellu, Paola Neroni, Angelica Dessì, Vassilios Fanos
In preterm infants, failure or delay in spontaneous closure of Ductus Arteriosus (DA), resulting in the condition of Patent Ductus Arteriosus (PDA), represents a significant issue. A prolonged situation of PDA can be associated with several short- and long-term complications. Despite years of researches and clinical experience on PDA management, unresolved questions about the treatment and heterogeneity of clinical practices in different centers still remain, in particular regarding timing and modality of intervention...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28720053/paracetamol-versus-ibuprofen-for-the-treatment-of-patent-ductus-arteriosus-in-preterm-neonates-a-meta-analysis-of-randomized-controlled-trials
#10
Xintao Huang, Fang Wang, Kai Wang
BACKGROUND: Paracetamol has been suggested as an effective treatment for patent ductus arteriosus (PDA). However, the comparative efficacy and safety between paracetamol and ibuprofen were not determined. METHODS: A meta-analysis of randomized controlled trials (RCTs) was performed. Relevant studies were identified via database searching. A fixed or random effect model was applied depending on the extent of heterogeneity. RESULTS: Five RCTs with 677 neonates were included...
August 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28558384/randomized-controlled-trial-comparing-different-single-doses-of-intravenous-paracetamol-for-placement-of-peripherally-inserted-central-catheters-in-preterm-infants
#11
Daniella W E Roofthooft, Sinno H P Simons, Richard A van Lingen, Dick Tibboel, John N van den Anker, Irwin K H Reiss, Monique van Dijk
BACKGROUND: The availability of a safe and effective pharmacological therapy to reduce procedural pain in preterm infants is limited. The effective analgesic single dose of intravenous paracetamol in preterm infants is unknown. Comparative studies on efficacy of different paracetamol doses in preterm infants are lacking. OBJECTIVES: To determine the analgesic effects of different single intravenous paracetamol doses on pain from peripherally inserted central catheter (PICC) placement in preterm infants...
2017: Neonatology
https://www.readbyqxmd.com/read/28395364/neurodevelopmental-outcomes-of-preterm-infants-treated-with-oral-paracetamol-versus-ibuprofen-for-patent-ductus-arteriosus
#12
Mehmet Yekta Oncel, Zeynep Eras, Nurdan Uras, Fuat Emre Canpolat, Omer Erdeve, Serife Suna Oguz
Objective  This study aims to determine the effects of paracetamol versus ibuprofen treatment given to preterm infants for the pharmacological closure of patent ductus arteriosus (PDA) on neurodevelopmental outcomes at 18 to 24 months' corrected age. Method  A follow-up study was conducted to evaluate the neurodevelopmental outcomes of preterm infants (gestational age ≤ 30 weeks) enrolled in a randomized controlled trial comparing oral paracetamol versus oral ibuprofen for the closure of PDA. The developmental assessment was done by using "Bayley Scales of Infant Development, Second Edition" at 18 to 24 months' corrected age...
October 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28004188/comparative-study-of-the-efficacy-and-safety-of-paracetamol-ibuprofen-and-indomethacin-in-closure-of-patent-ductus-arteriosus-in-preterm-neonates
#13
RANDOMIZED CONTROLLED TRIAL
Abd El-Rahman El-Mashad, Heba El-Mahdy, Doaa El Amrousy, Marwa Elgendy
In this prospective study, we compared the efficacy and side effects of indomethacin, ibuprofen, and paracetamol in patent ductus arteriosus (PDA) closure in preterm neonates. Three hundred preterm neonates with hemodynamically significant PDA (hs-PDA) admitted at our neonatal intensive care unit were enrolled in the study. They were randomized into three groups. Group I (paracetamol group) received 15 mg/kg/6 h IV paracetamol infusion for 3 days. Group II (ibuprofen group) received 10 mg/kg IV ibuprofen infusion followed by 5 mg/kg/day for 2 days...
February 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27698754/oral-paracetamol-vs-oral-ibuprofen-in-the-treatment-of-symptomatic-patent-ductus-arteriosus-in-premature-infants-a-randomized-controlled-trial
#14
Bo Yang, Xiangyu Gao, Yi Ren, Yun Wang, Qinglin Zhang
The aim of the present study was to analyze the changes of plasma and urinary prostaglandin E2 (PGE2 ) levels in preterm infants with symptomatic patent ductus arteriosus (sPDA) treated with oral ibuprofen and acetaminophen. A total of 87 preterm infants with sPDA admitted to the Neonatal Ward of the Affiliated Xuzhou Hospital of Medical College of Southeast University from October, 2012 to June, 2015 were selected and randomly divided into the ibuprofen group (n=43, 10 mg/kg ibuprofen administered orally as initial dose, followed by 5 mg/kg during the first 24 and 48 h later) and acetaminophen group (n=44, 15 mg/kg acetaminophen administered orally once every 6 h for three days)...
October 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27146832/intravenous-paracetamol-for-pda-closure-in-the-preterm-a-single-center-experience
#15
Enrico Valerio, Marta Rossella Valente, Sabrina Salvadori, Anna Chiara Frigo, Eugenio Baraldi, Paola Lago
UNLABELLED: Increasing recent evidence favors paracetamol use for patent ductus arteriosus (PDA) closure in preterms. Our study aims were (1) to assess efficacy and safety of intravenous (i.v.) paracetamol for PDA closure in a 23-32-week preterm population, as "first-line" (when traditional ibuprofen treatment was contraindicated) or "rescue" treatment (after ibuprofen failed), and (2) to identify predictors of PDA closure. The cumulative efficacy of consecutive cycles of i...
July 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27038924/efficacy-and-safety-of-intravenous-paracetamol-in-comparison-to-ibuprofen-for-the-treatment-of-patent-ductus-arteriosus-in-preterm-infants-study-protocol-for-a-randomized-control-trial
#16
RANDOMIZED CONTROLLED TRIAL
Carlo Dani, Chiara Poggi, Fabio Mosca, Federico Schena, Gianluca Lista, Luca Ramenghi, Costantino Romagnoli, Enrica Salvatori, Maria Teresa Rosignoli, Paola Lipone, Alessandro Comandini
BACKGROUND: Patent ductus arteriosus (PDA) is one of most common complications in preterm infants. Although ibuprofen represents the first choice for the closure of PDA, this treatment can cause severe gastrointestinal and adverse renal effects and worsen platelet function. The successful closure of the PDA with paracetamol has been recently reported in several preterm infants, and the safety of paracetamol for this use has been suggested by the available data. METHODS/DESIGN: We present the design of a randomized, multicenter, controlled study, whose aim is to assess the effectiveness and safety of intravenous paracetamol in comparison to intravenous ibuprofen for the treatment of PDA in preterm infants...
April 2, 2016: Trials
https://www.readbyqxmd.com/read/26951240/pharmacological-closure-of-patent-ductus-arteriosus-selecting-the-agent-and-route-of-administration
#17
REVIEW
Sindhu Sivanandan, Ramesh Agarwal
Opinions are divided regarding the management of a persistently patent ductus arteriosus (PDA). Some of the adverse effects associated with a large hemodynamically significant duct, including prolonged ventilation, pulmonary hemorrhage, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), and mortality, indicate that active management of infants with large ductal shunts may sometimes be necessary. Indomethacin and ibuprofen are the two US FDA-approved cyclooxygenase (COX) inhibitors used for the closure of a ductus in preterm babies...
April 2016: Paediatric Drugs
https://www.readbyqxmd.com/read/26897160/oral-paracetamol-for-closure-of-patent-ductus-arteriosus-in-selected-preterm-neonates
#18
Pankaj Kumar Mohanty, N Karthik Nagesh, Abdul Razak
We prospectively studied the effect of oral paracetamol in closing hemodynamically significant Patent ductus arteriosus in preterm infants (gestational age <32 weeks) where Ibuprofen was contraindicated. 29 of 40 neonates (72.5%) showed successful response while 11 (29.5%) failed to show any response. No major complications were seen.
February 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/26876125/recent-advances-in-the-treatment-of-preterm-newborn-infants-with-patent-ductus-arteriosus
#19
REVIEW
Hannes Sallmon, Petra Koehne, Georg Hansmann
A patent ductus arteriosus (PDA) is associated with several adverse clinical conditions. Several strategies for PDA treatment exist, although data regarding the benefits of PDA treatment on outcomes are sparse. Moreover, the optimal treatment strategy for preterm neonates with PDA remains subject to debate. It is still unknown whether and when PDA treatment should be initiated and which approach (conservative, pharmacologic, or surgical) is best for individual patients (tailored therapies). This article reviews the current strategies for PDA treatment with a special focus on recent developments such as oral ibuprofen, high-dose regimens, and the use of paracetamol (oral, intravenous)...
March 2016: Clinics in Perinatology
https://www.readbyqxmd.com/read/26862505/oral-medications-regarding-their-safety-and-efficacy-in-the-management-of-patent-ductus-arteriosus
#20
REVIEW
Mehmet Yekta Oncel, Omer Erdeve
Patent ductus arteriosus (PDA) is a common clinical condition in preterm infants which is inversely related to birth weight and gestational age. Cyclooxygenase inhibitors such as indomethacin and ibuprofen which block the prostaglandin conversion from arachidonic acid are the most commonly used drugs for ductal closure. This review focuses on the safety and efficacy oral medications in the management of PDA in preterm infants. Ibuprofen seems to be the first choice due to its higher safety profile, as it is associated with fewer gastrointestinal and renal side effects when compared to indomethacin...
February 8, 2016: World Journal of Clinical Pediatrics
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