• Mehmet Yekta Oncel, Sadik Yurttutan, Halil Degirmencioglu, Nurdan Uras, Nahide Altug, Omer Erdeve, and Ugur Dilmen.
• Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey. dryekta @ gmail.com
• Neonatology. 2013 Jan 1; 103 (3): 166-9.

BackgroundTreatment options for the closure of a hemodynamically significant patent ductus arteriosus (hsPDA) include medical therapy such as ibuprofen and indomethacin and surgical ligation.ObjectiveTo evaluate the efficacy of intravenous paracetamol in preterm infants with hsPDA whose feeding was contraindicated or had feeding intolerance.MethodsPreterm 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.ResultsA 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.ConclusionsThis 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 © 2012 S. Karger AG, Basel.

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