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Intravenous paracetamol was associated with closure of the ductus arteriosus in extremely premature infants
Author(s) -
Juujärvi S,
Saarela T,
Hallman M,
Aikio O
Publication year - 2018
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14137
Subject(s) - medicine , ductus arteriosus , ibuprofen , neonatal intensive care unit , anesthesia , incidence (geometry) , adverse effect , acetaminophen , cohort , pediatrics , surgery , physics , optics , pharmacology
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. Ductal closure dates, paracetamol medication details, morbidities and mortality data were evaluated. Results Intravenous paracetamol was given to 128 infants, starting at a median of 4.4 hours age (range: 0–169 hours), with a mean total dosage of 212 mg/kg (range: 7.5–1175 mg/kg). We also included 167 controls who were mainly treated before we used intravenous paracetamol. Ibuprofen (p < 0.001) and ligation (p = 0.002) were lower in the paracetamol group than controls. No adverse effects were detected. Paracetamol was not associated with other morbidities. Conclusion We found that early use of intravenous paracetamol decreased the incidence of ductal therapies in extremely premature or extremely low birthweight infants.