Vol. 1 No. 1 (2019): Randomized clinical trial to evaluate two guidelines for the administration of ibuprofen in the treatment of persistent ductus arteriosus eco-guided

Summary:

Patent ductus arteriosus (PDA) is a common condition of preterm infants and it is associated to significant morbidity and mortality. The best therapeutic option for PDA closure remains controversial. Necrotizing enterocolitis (NEC) and bowel spontaneous perforation have been observed in those infants who received pharmacologic treatment of PDA. Conventional treatment of PDA consists on 3 daily doses of intravenous (iv) ibuprofen in bolus 10-5-5 mg/kg/day. Recently, it has been shown that intravenous continuous infusion of ibuprofen (10-5-5 mg/kg/day) seems to be more efective for PDA closure than the convencional treatment with iv bolus. Our group demonstrated in a recent pilot study that the Echocardiographically guided trearment, EchoG, of PDA when it is compared with the convencional treatment, is feasible and reduces the number of ibuprofeno doses. Thus, EchoG treatment potentially reduces the adverse events associated to ibuprofen (i.e lower rate of NEC in the experimental group). This multicenter study will evaluate whether the combination of both experimental therapies (EchoG and iv continuous infusion) reduces the incidence of bowel adverse events (NEC and bowel spontaneous perforation) as compared with EchoG and iv ibuprofen bolus.