AI Article Synopsis
- Patent ductus arteriosus (PDA) is a significant health issue in very low birth weight infants, treated variably across Europe with non-steroidal anti-inflammatory drugs (NSAIDs), but lacks standardized guidelines.
- A survey sent to neonatal intensive care units in 19 European countries revealed that intravenous indomethacin is the most commonly used NSAID, with varying practices for treatment duration and recurrence.
- The findings highlight the need for established guidelines to ensure consistent and equitable care for newborns with PDA throughout Europe.
Article Abstract
Introduction: Patent ductus arteriosus (PDA) is a common cause of morbidity and mortality among very low birth weight infants and must be treated on an individual basis. Non-steroid anti-inflammatory drugs (NSAIDs) have been used in the treatment of PDA. However, no general guidelines have been followed.
Aim: To know the European reality on NSAIDs in the treatment of PDA in preterm newborns.
Methods: A questionnaire was sent to 24 European Societies of Neonatology and Perinatology to be filled, at least, by two neonatal intensive care units (NICUs) in each country, and to three representatives NICUs in Europe.
Results: We received 45 filled forms from 19 countries: 1 (2%) from North, 12 (27%) from East, 6 (13%) from West, and 26 (58%) from South Europe. Intravenous (iv) indomethacin is used in 32 (71%) NICUs (88% use a 30-60 min perfusion), iv ibuprofen in 16 (36%), and oral ibuprofen in 13 (29%). In 45% of NICUs a second course is used; 27% prescribed a third one. Prolonged treatment, 4-6 days, is mentioned by 45% of NICUs, in extremely low birth eight infants and after the failure of 3 courses of treatment. Prophylactic treatment is used in two NICUs, 24% treat no hemodynamically significant PDA, 96% treat with NSAIDs hemodynamically significant PDA and one NICU uses surgical closure as first line treatment. The ibuprofen/indomethacin contra-indications and preferences are similar to the literature. Pedea is the iv ibuprofen solution used and oral ibuprofen is a solution with 20 mg/ml. The choices are influenced by economical reasons in 22% of NICUs.
Conclusion: Our data show a wide variation among NICUs and countries, regarding the use of NSAIDs to treat PDA, and that no general guidelines are followed. Guidelines or recommendations are necessary to standardize treatment of PDA in Europe, in order to give to all newborns identical health care opportunities.
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| http://dx.doi.org/10.1080/14767050903198314 | DOI Listing |
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