Paracetamol for Patent Ductus Arteriosus Closure: High Osmolality of Enteral Form and Spontaneous Intestinal Perforation

Tuteja, Amrit; Pournami, Femitha; Kolisambeevi, Arif Abdulsalam; Nandakumar, Anand; Prabhakar, Jyothi; Jain, Naveen

doi:10.1007/s12098-020-03445-2

Cited by 3 publications

(1 citation statement)

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“…A striking case report outlines an incident wherein a premature infant developed spontaneous intestinal perforation after the oral administration of paracetamol with exceedinghly high osmolality ( Yurttutan & Güllü, 2021 ). In the realm of oral medication for preterm infants, an osmolality range of 330–350 mOsm/kg H 2 O is considered appropriate ( Tuteja et al, 2020 ). In our study, most of the included studies concerning ibuprofen reported the use of oral or rectal preparations with osmolalities between 300 and 400 mOsm/kg H 2 O.…”

Section: Discussionmentioning

confidence: 99%

The impact of the route of administration on the efficacy and safety of the drug therapy for patent ductus arteriosus in premature infants: a systematic review and meta-analysis

Luo,

He,

et al. 2024

PeerJ

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Background This systematic review and meta-analysis aims to explore the potential impact of the route of administration on the efficacy of therapies and occurrence of adverse events when administering medications to premature infants with patent ductus arteriosus (PDA). Method The protocol for this review has been registered with PROSPERO (CRD 42022324598). We searched relevant studies in PubMed, Embase, Cochrane, and the Web of Science databases from March 26, 1996, to January 31, 2022. Results A total of six randomized controlled trials (RCTs) and five observational studies were included for analysis, involving 630 premature neonates in total. Among these infants, 480 were in the ibuprofen group (oral vs. intravenous routes), 78 in the paracetamol group (oral vs. intravenous routes), and 72 in the ibuprofen group (rectal vs. oral routes). Our meta-analysis revealed a significant difference in the rate of PDA closure between the the initial course of oral ibuprofen and intravenous ibuprofen groups (relative risk (RR) = 1.27, 95% confidence interval (CI) [1.13–1.44]; P < 0.0001, I2 = 0%). In contrast, the meta-analysis of paracetamol administration via oral versus intravenous routes showed no significant difference in PDA closure rates (RR = 0.86, 95% CI [0.38–1.91]; P = 0.71, I2 = 76%). However, there was no statistically significant difference in the risk of adverse events or the need for surgical intervention among various drug administration methods after the complete course of drug therapy. Conclusion This meta-analysis evaluated the safety and effectiveness of different medication routes for treating PDA in premature infants. Our analysis results revealed that compared with intravenous administration, oral ibuprofen may offer certain advantages in closing PDA without increasing the risk of adverse events. Conversely, the use of paracetamol demonstrated no significant difference in PDA closure and the risk of adverse events between oral and intravenous administration.

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Section: Discussionmentioning

confidence: 99%

The impact of the route of administration on the efficacy and safety of the drug therapy for patent ductus arteriosus in premature infants: a systematic review and meta-analysis

Luo,

He,

et al. 2024

PeerJ

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Paracetamol

2020

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Acetaminophen Therapy for Persistent Patent Ductus Arteriosus

Manalastas¹,

Zaheer²,

Nicoski

et al. 2021

NeoReviews

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Persistence of a left-to-right shunt caused by a patent ductus arteriosus (PDA) leads to significant sequelae in extremely premature infants as a result of pulmonary overcirculation and systemic steal. Although timing and duration of treatment for a persistent clinically significant PDA differ among institutions, standard pharmacologic interventions are the nonsteroidal anti-inflammatory drugs indomethacin and ibuprofen. Acetaminophen has emerged as an alternative to indomethacin and ibuprofen with less significant adverse effects, but there is no consensus regarding its use. This review summarizes the most recent evidence for the use of acetaminophen in PDA treatment.

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Paracetamol for Patent Ductus Arteriosus Closure: High Osmolality of Enteral Form and Spontaneous Intestinal Perforation

Cited by 3 publications

References 5 publications

The impact of the route of administration on the efficacy and safety of the drug therapy for patent ductus arteriosus in premature infants: a systematic review and meta-analysis

The impact of the route of administration on the efficacy and safety of the drug therapy for patent ductus arteriosus in premature infants: a systematic review and meta-analysis

Paracetamol

Acetaminophen Therapy for Persistent Patent Ductus Arteriosus

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