The Efficacy of Repeated Courses of Ibuprofen in the Closure of Patent Ductus Arteriosus in Premature Infants Accepted Manuscript The Efficacy of Repeated Courses of Ibuprofen in the Closure of Patent[.]
Accepted Manuscript The Efficacy of Repeated Courses of Ibuprofen in the Closure of Patent Ductus Arteriosus in Premature Infants Ting-An Yen, M.D., MPH, Ching-Chia Wang, M.D., Ph.D PII: S1875-9572(17)30022-0 DOI: 10.1016/j.pedneo.2016.12.003 Reference: PEDN 636 To appear in: Pediatrics & Neonatology Received Date: 28 December 2016 Accepted Date: 28 December 2016 Please cite this article as: Yen T-A, Wang C-C, The Efficacy of Repeated Courses of Ibuprofen in the Closure of Patent Ductus Arteriosus in Premature Infants, Pediatrics and Neonatology (2017), doi: 10.1016/j.pedneo.2016.12.003 This is a PDF file of an unedited manuscript that has been accepted for publication As a service to our customers we are providing this early version of the manuscript The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain 57010175_Editorial_final ACCEPTED MANUSCRIPT The Efficacy of Repeated Courses of Ibuprofen in the Closure of Ting-An Yen1, M.D., MPH, Ching-Chia, Wang2, M.D., Ph.D Department of Emergency, National Taiwan University Hospital, National Taiwan SC University College of Medicine, Taipei, Taiwan Department of Pediatrics, National Taiwan University Hospital, National Taiwan M AN U RI PT Patent Ductus Arteriosus in Premature Infants University College of Medicine, Taipei, Taiwan Corresponding author: Ching-Chia, Wang, M.D., Ph.D TE D Department of Pediatrics, Medicine EP National Taiwan University Hospital and National Taiwan University College of AC C No 8, Chung-Shan South Road Taipei, 100, Taiwan TEL: 886-2-23123456 ext 71616 Fax: 886-2-23278607 E-mail: ccwangy1@ntu.edu.tw ACCEPTED MANUSCRIPT Patent ductus arteriosus (PDA) is a common condition in premature infants and is associated with various prematurity-related morbidities if left untreated.1 A RI PT hemodynamically significant PDA (hsPDA) can decrease systemic flow with left to right shunting, which is attributable to intraventricular hemorrhage, necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), and bronchopulmonary SC dysplasia.2 Ibuprofen, a propionic acid derivative and a non-selective cyclooxygenase M AN U (COX) inhibitor, has been reported to be as effective to close a PDA as indomethacin with less adverse effects, including gastrointestinal, cerebral, and renal hemodynamic effects Orogastric administration of ibuprofen, compared to intravenous ibuprofen, was demonstrated to have the same efficacy with fewer adverse effects.3 In addition to TE D pharmacological management, surgical ligation or percutaneous transcatheter devices are other treatment choices for PDA closure.2 EP In most clinical practices, surgical ligation is the alternative treatment following AC C failure of PDA closure after repeated courses of COX inhibitors Nevertheless, surgical ligation is associated with an increased risk of neurodevelopment impairment, chronic lung disease, and severe ROP.4 Therefore, the purpose of the present study was to research the efficacy and safety of repeated courses of COX inhibitor The most recent studies with relatively large study populations have demonstrated the efficacy of repeated courses of ibuprofen.4,5,6 In the study of Richards et al 5, authors ACCEPTED MANUSCRIPT investigated the rate of PDA closure in a population of infants with