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1125 Efficacy of an Individualized Strategy for the Pharmacological Closure of PDA with Ibuprofen in Preterm Infants: Evaluation by Echocardiography
  1. S Galletti,
  2. A Cosentino,
  3. A Malavolti,
  4. E Machtey,
  5. G Faldella
  1. Neonatology and Intensive Care Unit - Sant’Orsola-Malpighi Hospital - University of Bologna, Bologna, Italy


Background and Aims The aim of study is to evaluate the applicability of an individualized strategy for closure of PDA in preterms. We verified the closure rate and consequently the failure of PDA closure, the rate of reopening and the onset of secondary outcomes.

Methods We recruited 36 preterms (27 weeks mean GA; mean birth weight 828 g) with PDA and candidates for the pharmacological closure according to the internal protocol.

Using serial ECHOS, we evaluated the persistence of the PDA after the administration of a first dose of ibuprofen, establishing the need to repeat a second or third dose each 24 hours.

Results We observed a rate of complete closure of 77.7% (33.3% after the first dose, 30.5% after the second and 13.8% after the third dose).

The incidence of re-opening is 16.6%, without significant difference related to the number of doses (p=1).

There was a significant difference in terms of birth weight and GA between patients with persistent PDA (mean BW 485 g and mean GA 24+3) and patients who kept the ductus closed (mean BW 901.4 g and GA 27) (p<0.05).

There was no significant difference in terms of incidence of outcomes (IVH, NEC, broncodisplasia, deaths) comparing to a group which received a standard treatment of 3 doses.

Conclusion The individualized strategy allows to expose preterms to a minor amount of doses, without changing the number of closure and outcomes.

However, the extreme GA are associated with an increased risk of failure of closure and reopening.

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