Intravenous Paracetamol Treatment in the Management of Patent Ductus Arteriosus in Extremely Low Birth Weight Infants
Intravenous Paracetamol Treatment in the Management of Patent Ductus Arteriosus in Extremely Low Birth Weight Infants
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DOI：
10.1159/000345337
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发表时间：
2013-01-01
期刊：
影响因子：
2.5
通讯作者：
Dilmen, Ugur
中科院分区：
文献类型：
--
作者：
Oncel, Mehmet Yekta;Yurttutan, Sadik;Dilmen, Ugur
背景资料：血流动力学显著动脉导管未闭（hsPDA）的治疗选择包括药物治疗（如布洛芬和吲哚美辛）和手术结扎。目的：评价静脉注射对乙酰氨基酚对喂养禁忌或喂养不耐受的hsPDA早产儿的疗效。方法：hsPDA早产儿在父母同意下开始静脉注射对乙酰氨基酚治疗。对乙酰氨基酚以60 mg/kg/天的剂量分4次给药，持续3天。在hsPDA未闭合的情况下，治疗延长至6天，之后进行超声心动图检查。结果如下：研究共纳入10例早产儿，中位胎龄为27（4/7）周（最小-最大：24-29），中位出生体重为775 g（590-990）。第一剂静脉注射对乙酰氨基酚的时间中位数为6天（2-15天）。超声心动图检查，导管内径中位数为2 mm（1.5-3），左心房与主动脉根比值中位数为1.95（1.6-2.2）。静脉注射对乙酰氨基酚导致所有患者hsPDA成功闭合。结论：本研究是文献中首次使用静脉注射对乙酰氨基酚治疗hsPDA的病例系列。我们认为，静脉注射扑热息痛可作为婴儿的替代药物。需要进一步的前瞻性随机对照试验来评价静脉注射对乙酰氨基酚闭合hsPDA的疗效。版权所有（C）2012 S. Karger AG，巴塞尔
Background: Treatment options for the closure of a hemodynamically significant patent ductus arteriosus (hsPDA) include medical therapy such as ibuprofen and indomethacin and surgical ligation. Objective: To evaluate the efficacy of intravenous paracetamol in preterm infants with hsPDA whose feeding was contraindicated or had feeding intolerance. Methods: Preterm infants with hsPDA were started on intravenous paracetamol treatment with parental consent. Paracetamol was administered at a dose of 60 mg/kg/day, in four divided doses, for a period of 3 days. In the absence of closure of hsPDA, treatment was extended up to 6 days, after which echocardiographic examination was performed. Results: A total of 10 preterm infants were included in the study with a median gestational age of 27(4/7) weeks (minimum-maximum: 24-29) and a median birth weight of 775 g (590-990). The first dose of intravenous paracetamol was given after a median of 6 days (2-15). On echocardiographic examination, median internal ductal diameter was 2 mm (1.5-3), with a median left atrium-to-aortic root ratio of 1.95 (1.6-2.2). Intravenous paracetamol resulted in successful closure of hsPDA in all patients. Conclusions: This study is the first case series in the literature which used intravenous paracetamol treatment for hsPDA. We believe that intravenous paracetamol could be used as an alternative drug for infants. Further prospective randomized-controlled trials are needed to evaluate the efficacy of intravenous paracetamol for the closure of hsPDA. Copyright (C) 2012 S. Karger AG, Basel