Paracetamol-responsive patent ductus arteriosus in a late preterm very low birth weight neonate at 4 weeks postnatal age

Abstract

Pharmacological closure with cyclooxygenase (COX) inhibitors, such as indomethacin and ibuprofen, forms the first line of treatment for a patent ductus arteriosus (PDA) in preterm neonates. However, their efficacy decreases with increasing postnatal and postconceptual age. Paracetamol is gaining acceptance worldwide as an alternative drug for PDA closure and can be used when COX inhibitors are contraindicated, although its efficacy at advanced postnatal age is not well described. Here, we describe a late preterm neonate (36 weeks, 1150 g birth weight) with a hemodynamically significant PDA, where COX inhibitor therapy could not be initiated due to thrombocytopenia, and where oral paracetamol was started at 4 weeks postnatal age and caused ductal closure after a 6-day course.

Keywords

• Neonatology
• patent ductus arteriosus (PDA)
• pediatric cardiology