What is the role of ibuprofen in the treatment of patent ductus arteriosus (PDA)?

Updated: Nov 20, 2018
  • Author: Luke K Kim, MD; Chief Editor: Stuart Berger, MD  more...
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Prophylactic ibuprofen is also widely used. The dose used for ibuprofen is 10 mg/kg bolus followed by 5 mg/kg/d for 2 additional days.

When compared with indomethacin, ibuprofen is associated with a lower risk of oliguria in preterm infants. However, one study showed an increased risk of pulmonary hypertension in patients. The Cochrane evaluation on ibuprofen prophylaxis concluded that although prophylactic ibuprofen use reduces the incidence of patent ductus arteriosus (PDA) on day 3, potential adverse effects should be further addressed that also look at neurodevelopmental outcomes. [13]

Patent ductus arteriosus (PDA) closure is gestation dependent, with a cumulative closure rate of 65%. A similar proportion of infants had patent ductus arteriosus (PDA) closure following first and second courses of ibuprofen, regardless of gestation, suggesting that a second course of ibuprofen may be effective in closing a patent ductus arteriosus (PDA), obviating the need for surgery. [14]

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