Uso del paracetamol para el cierre del conducto arterioso en recién nacidos con edad gestacional menor a 35 semanas

Objective

To describe the experience with the use of paracetamol in the pharmacological closure of the patent ductus arteriosus with haemodynamic repercussion.

Material and methods

A retrospective observational study was conducted from 1 January 2014 to 1 June 2017, in a population of less than 35 weeks of gestation, less than 5 days of life. A total of 70 cases were included and 10 were excluded. Out of the remaining 60 cases, and of these, 6 were offered a second cycle of haemodynamic repercussion. Intravenous paracetamol was used at a dose of 15 mg per kg every 6 hours, for a total of twelve doses, on those with persistence of the ductus arteriosus, with hemodynamic repercussion. Platelets, liver and kidney function tests were performed, including a transfontanelle ultrasound at 24 hours before and after each cycle, as well as a record of the fluid balance from the first to the fifth day.

Results

Gestational age and birth weight was unrelated to the closure of the ductus arteriosus (P = .622 and P = .215). The use of the prenatal corticosteroids is revalidated as a favourable factor for the closure of the patent ductus arteriosus (P < .001). An effectiveness of 90% was obtained in a total of 60 patients. There was no evidence of interventricular bleeding in the first cycle. There was no increase in liver enzymes or renal function. Two patients died during the study.

Conclusions

Paracetamol for the closure of the ductus arteriosus, in contraindication of ibuprofen, showed adequate effectiveness and safety in affected neonates in the city of Bogotá.