Second Course of Therapy for Resistant Patent Ductus Arteriosus (PDA)

Shaare Zedek Medical Center

Status and phase

Withdrawn

Phase 2

Conditions

Patent Ductus Arteriosus

Treatments

Drug: Indomethacin

Drug: Ibuprofen

Study type

Interventional

Funder types

Other

Identifiers

NCT01070745

chammerman3

Details and patient eligibility

About

Patency of the ductus arteriosus (PDA) is functionally essential for fetal circulation, however persistence of ductal patency postnatally may have significant adverse hemodynamic effects in the neonate. Medical therapy for PDA predominantly involves the administration of one of two non-steroidal anti-inflammatory drugs: indomethacin or ibuprofen. Both of these therapies have been shown to be successful in mediating ductal closure in approximately 70% of treated infants.

However, the need for a second course of treatment for PDA closure remains quite common. The investigators hypothesize that, because of small differences between the two drugs, a greater percentage of infants who did not respond to a first course of therapy with indomethacin will respond to a second course with ibuprofen than to a repeat course of indomethacin.

As such, the investigators aim to compare secondary therapy with a repeat course of indomethacin to secondary therapy with ibuprofen in infants whose ductus remained patent after a first course of therapy with indomethacin.

Sex

All

Ages

2 days to 2 months old

Volunteers

No Healthy Volunteers

Inclusion criteria

Inborn premature neonates (birth weight [BW] <1500 grams) being treated in the neonatal intensive care unit of the Shaare Zedek Medical Center and diagnosed as still having a hemodynamically significant patent ductus arteriosus (hsPDA) after a first course of therapy with indomethacin, will be considered as potential candidates for study pending response to initial therapy and pending parental consent.

Exclusion criteria

Any baby not considered viable
Any baby with intraventricular hemorrhage (IVH) grade 3-4 of recent onset (within 3 days). [If no head ultrasound has been performed within the last 3-4 days, one should be performed prior to onset of study.]
Any baby with dysmorphic features or congenital abnormalities
Any baby with structural heart disease other than PDA
Any baby with documented infection,
Any baby with thrombocytopenia (<50,000).