Evaluation to efficacy of intravenous paracetamol use for the treatment of patent ductus arteriosus in the neonatal intensive care unit

Introduction: Patent ductus arteriosus (PDA) which may cause significant hemodynamic instability in newborn infants can be treated with pharmacologic or surgical methods. Surgical treatment is applied in cases which do not respond to pharmacological treatment. The most commonly used drugs for this purpose are cyclooxygenase inhibitors, mainly indomethacin and ibuprofen, while oral or intravenous paracetamol in infants has become to use in cases these drugs are contraindicated or can not take oral, in the recent years. In our study, we aimed to determine the effectiveness intravenous paracetamol on closure of hemodynamically significant PDA and we aimed to compare it with indomethacin and ibuprofen according to its haematological side effects. Materials and Methods: This retrospective study in conducted between November 2014 and December 2015 in Abant Izzet Baysal University Training and Research Hospital, Children's Health and Disease, Neonatal Intensive Care Unit. Intravenous paracetamol is used at 4 x 15mg/kg/dose 3-6 days in hospitalised patients diagnosed with PDA and having contraindication for indomethacin and ibuprofen. Results: A total of 10 PDA diagnosed cases has been treated with paracetamol between November 2014 and December 2015. One patient had increased BUN level, two cases had increased ACT levels and two patients had trombocytopenia in pretreatment phase. After treatment all laboratory values were reached to normal levels and the patients hemodynamic status improved after closure of PDA. Conclusions: Considering its effectiveness in PDA closure and its better hematological side effect profile compared to other known therapeutic agents and easily found in our country, it was concluded that paracetamol may be an important option in the treatment of PDA.