Ibuprofen for PDA?

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Our neo prescribed ibuprofen of two babies on our unit both w/moderate PDA. I found some research and everything I've read talks about it being given IV, our babes were given orally as its not available as IV in her in the US. Is anyone else using this to treat PDA's on thier units? Both kiddo's have echo's tomorrow and I don't hear the murmur on one but she still desats as though she's shunting so I guess we'll see. A couple of weeks we had an little one that after one dose of Indocin went into renal failure (no urine output at all, sky high BUN and Creatanin)and sadly didn't make it, so maybe he's trying a different modality because of her poor outcome.

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Specializes in Education, FP, LNC, Forensics, ED, OB.
Our neo prescribed ibuprofen of two babies on our unit both w/moderate PDA. I found some research and everything I've read talks about it being given IV, our babes were given orally as its not available as IV in her in the US. Is anyone else using this to treat PDA's on thier units? Both kiddo's have echo's tomorrow and I don't hear the murmur on one but she still desats as though she's shunting so I guess we'll see. A couple of weeks we had an little one that after one dose of Indocin went into renal failure (no urine output at all, sky high BUN and Creatanin)and sadly didn't make it, so maybe he's trying a different modality because of her poor outcome.

Hello, leepgirl,

We have had a good success rate of closure in the preterm infants around 32 weeks after two doses. IB is less traumatic on the renal system. Still have the rise in creatinine and decreased output, but, to a lesser extent.

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Specializes in NICU.
Hello, leepgirl,

We have had a good success rate of closure in the preterm infants around 32 weeks after two doses. IB is less traumatic on the renal system. Still have the rise in creatinine and decreased output, but, to a lesser extent.

Did you give the IV form? So is it or is it not available in the US? I'm really looking forward to trialing it sometime in the future. It seems much more gentle. With indocin, we've seen some renal failure (almost always transient) and spontaneous bowel perforations (often on babies who'd never even had enteral feeds).

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Specializes in Education, FP, LNC, Forensics, ED, OB.
Did you give the IV form? So is it or is it not available in the US? I'm really looking forward to trialing it sometime in the future. It seems much more gentle. With indocin, we've seen some renal failure (almost always transient) and spontaneous bowel perforations (often on babies who'd never even had enteral feeds).

No, it was not IV. We did administer IB before 72 hours lapsed after dx of PDA. That does seem to be a factor in the success, too.

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Sounds good we've never tried this before. Too bad it doesn't come in iv form. Does it mean that it's much suitable for the bigger babies? What about the smaller ones - 25weekers?

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This is interesting because we keep our kiddos NPO until the PDA is closed. And they would never start oral meds until they are on max feeds.

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Specializes in Nursing Professional Development.

I would worry about the effects on the stomach and on the ears as well. Ibuprofin is very ototoxic -- and a lot of adults have trouble taking it because it is so harsh on the stomach.

Really ... I think if it were my kid, I'd almost rather see them have the surgery. I've seen very few bad outcomes with the surgery. It's a quick procedure that only takes a few minutes. While I AM half-joking about that ... I'm only HALF joking!

llg

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