Pharmacological closure and maintaining patency of ductus arteriosus

Johnson Francis | December 6, 2022 | General Cardiology | No Comments

Pharmacological closure and maintaining patency of ductus arteriosus

Prostaglandin E1 is used for maintaining ductal patency in ductus dependent circulations [1]. Both oral [2] and intravenous paracetamol [3] have been used for pharmacological closure of patent ductus arteriosus in newborns. Indomethacin was the earlier drug being used for pharmacological ductal closure, but seldom used now because of its adverse effects. Then came ibuprofen, which is still being used. Paracetamol is the latest addition, with a better side effect profile than ibuprofen.

Ductus dependent circulations are classified into ductus dependent pulmonary circulations and ductus dependent systemic circulations. Both worsen after birth at the time of spontaneous ductal closure.

References

1. Huang FK, Lin CC, Huang TC, Weng KP, Liu PY, Chen YY, Wang HP, Ger LP, Hsieh KS. Reappraisal of the prostaglandin E1 dose for early newborns with patent ductus arteriosus-dependent pulmonary circulation. Pediatr Neonatol. 2013 Apr;54(2):102-6.
2. Bagheri MM, Niknafs P, Sabsevari F, Torabi MH, Bahman Bijari B, Noroozi E, Mossavi H. Comparison of Oral Acetaminophen Versus Ibuprofen in Premature Infants With Patent Ductus Arteriosus. Iran J Pediatr. 2016 May 15;26(4):e3975.
3. Valerio E, Valente MR, Salvadori S, Frigo AC, Baraldi E, Lago P. Intravenous paracetamol for PDA closure in the preterm: a single-center experience. Eur J Pediatr. 2016 Jul;175(7):953-66.

About The Author

Johnson Francis

Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal