No abstract

Background: One of the most significant changes needed for the transition to extrauterine life is the ductus arteriosus (DA) closure, which is located in the fetal circulatory system between both the aortic arch and the pulmonary artery. The extended length of patent DA (PDA), that further raises premature mortality and morbidity, impairs hemodynamics. The effectiveness and tolerability of oral ibuprofen administered at regular and high doses to treat PDA were examined in this research. Patients and Methods: The newborn Critical Care Unit at Cairo University Pediatric Hospitals received 60 preterm neonates (Gestational age<36 weeks) with clinically severe PDA during the course of 2.5 years. A randomized controlled trial was used in the investigation. They were divided into two groups at random, with the first receiving oral ibuprofen at a standard dose (10, 5, 5 mg/kg/day) and the second receiving oral ibuprofen at a high dose (20, 10, 10 mg/kg/day) for three days straight. Results:The neonates in our experiment exhibited a considerable reduction in PDA size both before and after taking it, and no statistical considerable difference between two regimens of ibuprofen was existent. Despite the fact they stayed within the scope of normal range for age in the high-dose group, serum creatinine level rose by two to three times following ibuprofen treatment. To completely comprehend this conclusion, further study is needed. Conclusions: Our results show that regular-dose ibuprofen for PDA closure is just as effective as high-dose ibuprofen with fewer side effects.

Background: Pathological coagulation system activation is linked to neonatal sepsis, which leads to disseminated intravascular coagulation. Late-onset sepsis (LOS) in preterm neonates leads to serious morbidities and increased mortality. Aim and objectives: The purpose of this research was to assess how pentoxifylline affectes protein C in septic preterm infants as well as their clinical development and outcomes. Patients and methods: Eighty preterm newborns who were hospitalized in Kasr Alaini, Cairo University Hospital's neonatal critical care units and with clinical or blood culture-proven LOS participated in this double-blinded, randomized controlled experiment. The pentoxifylline group got pentoxifylline (5 mg/kg/hour for six hours), whereas the control group received normal saline as a placebo. Both infusions were administrated for six successive days. Protein C levels were measured before and after the intervention. Result: Gram-negative sepsis was predominant with Klebsiella pneumonia being the most common isolated organism. After the intervention, there was a significant increase in protein C levels in the pentoxifylline group (P value = 0.020). Significant reductions in the duration of antimicrobial therapy,duration of hospital stay in survivors and continuous positive airway pressure therapy, (P values =0.001, 0.012 and 0.03 respectively) were documented, as well as the decreased requirement for plasma transfusions (P value = 0.03). Conclusion:In preterm newborns with LOS, pentoxifylline has a good impact on the protein C system and lengths of antibiotic treatment, hospital stay and continuous positive airway pressure therapy.