Background IBU is equivalent to IND for PDA-treatment. IBU reduces less cerebral, mesenteric and renal perfusion and platelet function. IND-INF seems to have similar effects on circulation, but the clinical efficacy of this approach is unclear.
Aim To compare the efficacy and safety of PDA-treatment using 36-hour IND-INF vs IBU in preterm infants.
Methods Retrospective matched-pair cohort-analysis of infants <28GA from a tertiary centre (2012–2014). Infants matched for: Chorioamnionitis, antenatal steroids, vaginal delivery, GA, birthweight, gender, surfactant-administration, mechanical-ventilation, oxygen-requirement (FiO2), PDA-width (wPDA), inotropes, fluid-intake, plasma sodium (SOD), plasma-creatinine (CREA), platelet count (THROM), cerebral resistance-index (cRI) and treatment-age. Outcome measures: wPDA, number of closed (cPDA), restrictive (rPDA), re-opened (rePDA) PDA; FiO2, BPD, SOD, CREA, intestinal perforation (IP), necrotising enterocolitis (NEC), THROM, cRI, IVH, ROP, mortality. Data-presentation: Median (interquartile range) or ratio (n/N). Data-analysis: Fisher’s-Exact-/Mann-Whitney-Test (p < 0.05).
Results 16 newborns (8 IND-INF/8 IBU) recruited. Baseline-characteristics (GA 26 [25–27] vs 26 [25–26], p = 0.65; birthweight 842 g [597–925] vs 777 g [730–801], p = 0.88; rest not displayed) and outcomes were not significantly different:
Conclusion IND-INF appears to be as safe as IBU whilst maintaining the same efficacy for treatment of symptomatic PDA in newborns <28 GA.