Platelet Count and Volume and Pharmacological Closure with Paracetamol of Ductus Arteriosus in Preterm Infants
Carlo Dani,
Martina Ciarcià,
Francesca Miselli,
Michele Luzzati,
Caterina Coviello,
Angela Paladini,
Anthea Bottoni,
Vito D’Andrea,
Giovanni Vento
Affiliations
Carlo Dani
Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50134 Florence, Italy
Martina Ciarcià
Division of Neonatology, University of Florence, 50134 Florence, Italy
Francesca Miselli
Division of Neonatology, University of Florence, 50134 Florence, Italy
Michele Luzzati
Division of Neonatology, University of Florence, 50134 Florence, Italy
Caterina Coviello
Division of Neonatology, University of Florence, 50134 Florence, Italy
Angela Paladini
Division of Neonatology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of Sacred Heart, 20123 Rome, Italy
Anthea Bottoni
Division of Neonatology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of Sacred Heart, 20123 Rome, Italy
Vito D’Andrea
Division of Neonatology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of Sacred Heart, 20123 Rome, Italy
Giovanni Vento
Division of Neonatology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of Sacred Heart, 20123 Rome, Italy
Background: Low platelet count might promote resistance to pharmacological closure with indomethacin and ibuprofen of a hemodynamically significant patent ductus arteriosus (hsPDA). However, no studies have investigated if this occurs with paracetamol. Methods: We retrospectively assessed the correlation between platelet count, mean platelet volume (MPV), and plateletcrit (PCT), as well as the effectiveness of paracetamol in closing hsPDA in infants born at 23+0–31+6 weeks of gestation who were treated with 15 mg/kg/6 h of i.v. paracetamol for 3 days. Results: We studied 79 infants: 37 (47%) Had closure after a course of paracetamol and 42 (53%) did not. Platelet count and PCT did not correlate with paracetamol success or failure in closing hsPDA, while MPV was lower at birth (10.7 ± 1.4 vs. 9.5 ± 1.1; p p = 0.079) in refractory infants. Regression analysis confirmed that the low MVP measured prior to starting the treatment increased the risk of hsPDA paracetamol closure failure (OR 1.664, 95% CI 1.153–2.401). Conclusions: The greater MPV correlated positively with the effectiveness of paracetamol in closing hsPDA, while platelet count and PCT did not influence closure rates. Additional studies are needed to confirm our results.
