27 Jan 2024 • A variety of treatment strategies have been implemented for management of PDA in extremely premature infants. What is the impact of selective early treatment of large patent ductus arteriosus (PDA) with ibuprofen in extremely preterm infants?

• Patients were enrolled and received treatment ≤72 hours after birth if they were 23 weeks to 28-6/7 weeks’ gestation and had a PDA ≥1.5 mm with pulsatile flow. The primary outcome was a composite of death or moderate or severe bronchopulmonary dysplasia.
• Early administration of ibuprofen in extremely premature infants (<29 weeks’ gestation) with large patent ductus arteriosus (PDA) did not result in improvement in survival or decrease the risk of moderate or severe bronchopulmonary dysplasia.
• Ibuprofen administration resulted in decrease in size or resolution of the PDA in 55.5% of patients, as compared with 37.5% in the placebo group.

Overall, this study does not support the use of ibuprofen to improve mortality or decrease risk of bronchopulmonary dysplasia in extremely premature infants with PDA.

Source: NEJM | Read full story