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Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
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Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence

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Treatment of patent ductus arteriosus: indomethacin or ibuprofen?

K C Sekar1, K E Corff

  • 1Department of Pediatrics, Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. kris-sekar@ouhsc.edu

Journal of Perinatology : Official Journal of the California Perinatal Association
|June 18, 2008
PubMed

Insights

Persistent patent ductus arteriosus (PDA) in preterm infants requires prompt treatment. Cyclo-oxygenase (COX) inhibitors like indomethacin and ibuprofen are effective, but surgical ligation is reserved for treatment failures, carrying long-term risks.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Pharmacology

Background:

  • Persistent patent ductus arteriosus (PDA) in preterm infants leads to significant hemodynamic changes and morbidities.
  • Untreated PDA within the first week of life can cause respiratory, gastrointestinal, and renal complications.

Purpose of the Study:

  • To review the medical considerations for treating PDA in premature infants.
  • To compare the efficacy and side effects of available treatment options for PDA.

Main Methods:

  • Review of current treatment modalities for PDA in preterm neonates.
  • Comparison of pharmacological agents (indomethacin, ibuprofen) and surgical ligation.
  • Analysis of drug-specific effects on morbidities like intraventricular hemorrhage (IVH) and organ perfusion.

Main Results:

  • Indomethacin and ibuprofen lysine are equally effective COX inhibitors for PDA closure.
  • Indomethacin offers IVH protection but may reduce renal and cerebral blood flow; ibuprofen is less toxic but lacks IVH benefits.
  • Surgical ligation is effective for refractory PDA but associated with long-term neurological and respiratory issues.

Conclusions:

  • Treatment choice for PDA in preterm infants depends on balancing efficacy, timing, and potential adverse effects.
  • Pharmacological interventions are preferred early, with surgery as a last resort due to associated morbidities.

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