Expectant Management or Early Ibuprofen for Patent Ductus Arteriosus
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- Expectant management for PDA in preterm infants is non-inferior to early ibuprofen treatment in this multicenter trial (n=273).
- Expectant management group had lower BPD rates (33% vs 50%) compared to early ibuprofen, though NEC and mortality were similar.
- Early ibuprofen did not demonstrate clear benefit over watchful waiting for hemodynamically significant PDA in preterm neonates.
- Consider deferring pharmacologic PDA treatment in stable preterm infants given comparable outcomes with expectant approach.
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Do you use ibuprofen for PDA? Hi, I'm Cecilia Higuena from Cincinnati Children's Hospital, and I think this is an article that you should know about. This is a multicenter non-inferiority trial that compared preterm infants treated with expectum management versus early ibuprofen for PDA. And what did they find? They had 273 infants. 136 were treated with expectum management and 137 with early ibuprofen. In the expectum management group, they got 17.6% of necrotizing enterocolitis, 33% of bronchopulmonary dysplasia, and 14% of death rates. Whereas in the ibuprofen group, they got 15.4% of necrotizing enterocolitis, 50% of bronchopulmonary dysplasia, and 18% of death rates. So, it seems that expectum management is not inferiority than early ibuprofen in preterm patients with PDA. Let us know what you think and stay tuned for more articles that you should know about.