Paracetamol versus ibuprofeno como tratamento de ductus arterioso persistente en recién nacidos pretérmino. Revisión bibliográfica

Abstract

Background: in the fetal circulation, the ductus arteriosus connects the proximal descending aorta with the left branch of the pulmonary artery, diverting cardiac output from the lungs to the placenta for increased systemic oxygenation. At birth, the lungs become the main source of oxygen, so the ductus arteriosus is no longer needed. In most term newborns it closes until three days after birth. Congenital heart disease related to patent ductus arteriosus is the third cause of mortality in Ecuador; It occurs in 60% of cases in newborns ≤ 28 weeks of gestation. Currently, the pharmacological treatment of choice includes the use of non-steroidal anti-inflammatory drugs (NSAIDs) and in case of failure requires surgical intervention. Methodology: narrative-type bibliographic review, where a search strategy for updated articles in Spanish and English will be carried out in databases such as PubMed, Scopus and Science Direct. 39 articles were used for this bibliographic review. Objective: to compare paracetamol versus ibuprofen as a treatment for patent ductus arteriosus in preterm neonates. Results: paracetamol proved to be just as efficient as ibuprofen for the treatment of patent ductus arteriosus. In the studies, doses of ibuprofen of 10/5/5 mg/kg/day and paracetamol of 15 mg/kg/6h for three days were used. In patients who were managed with ibuprofen, an increase in the incidence of transient acute kidney injury, elevated bilirubin levels, interventricular hemorrhage, and gastrointestinal bleeding was observed. There is no evidence of long-term complications in neurological development in patients treated with paracetamol.