Patent Ductus Arteriosus After Premature Birth Clinical Trial
Official title:
Paracetamol Versus Ibuprofen in Premature Infants With Hemodynamically Significant Patent Ductus Arteriosus: a Randomized Clinical Trial
Multicentric, double-blind clinical trial, which will evaluate the efficacy of iv paracetamol versus standard treatment with ibuprofen in the closure of patent ductus arteriosus in the preterm newborn. Secondarily, we intend to compare the safety of both treatments, increase our knowledge about the pharmacokinetics, pharmacodynamics and pharmacogenetics of paracetamol and ibuprofen in the neonatal period and make a pharmacoeconomic assessment of the use of both drugs.
Those newborns ≤ 30 weeks of gestational age who are diagnosed in the first 2 weeks of
hemodynamically significant ductus arteriosus and who do not meet any exclusion criteria will
be eligible to participate in the study.
The PARACETAMOL group will receive intravenous doses of 15 mg/kg administered every 6h for 3
days (up to a maximum of 2 courses, i.e. 6 days). The IBUPROFEN group (control group) will
receive the usual treatment, this is an initial dose of 10 mg/kg followed by 5 mg/kg
intravenously at 24 and 48 hours after the first (all three doses are considered a treatment
course), up a maximum of 2 courses).
A daily echocardiographic control will be performed to evaluate the closure of the ductus. If
the ductus remains open and with significant clinical repercussion after completing a 3-day
course of treatment, another batch of 3 doses of the same treatment will be administered. If
medical treatment fails after two courses (6 days), the possibility of administering a batch
of Ibuprofen at usual doses in both groups with the intention of offering standard treatment
to all patients will be considered. Once the medical treatment with both drugs is completed
if the ductus remains significant, the surgical closure will be carried out.
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