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David S. Waworuntu
Universitas Sam Ratulangi
Health Professions

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Efficacy of Paracetamol Compared to Ibuprofen on Closure of Patent Ductus Arteriosus in Premature Infants Alviolita P. Rondonuwu; Johnny L. Rompis; David S. Waworuntu
e-CliniC Vol. 10 No. 2 (2022): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v10i2.37701

Abstract

Abstract: Patent ductus arteriosus (PDA) is a congenital heart disease caused by failure of the ductus arteriosus to close immediately after birth. PDA can cause hemodynamic disturbances in premature infants as well as increased morbidity and mortality. Therefore, it needs to be closed immediately. Closuring of the PDA can use ibuprofen as a cyclooxygenase (COX) inhibitor, however, there are potential side effects. Paracetamol can be used as an alternative that acts as a peroxidase (POX) inhibitor with few side effects. This study aimed to compare the efficacy of paracetamol and ibuprofen on PDA closure in premature infants. This was a literature review, using four databases, such as Pubmed, ClinicalKey, Cochrane and ScienceDirect. The keywords used were paracetamol AND ibuprofen AND patent ductus arteriosus AND preterm AND newborn. Selection with inclusion and exclusion criteria obtained 13 articles. Paracetamol was as effective as ibuprofen for PDA closure therapy in premature infants. Paracetamol was safer than ibuprofen due to ibuprofen’s side effects. In conclusion, paracetamol is as effective as ibuprofen and is safer to be used in PDA closure therapy in premature babies.Keywords: paracetamol; ibuprofen; patent ductus arteriosus; preterm; newborn Abstrak: Patent ductus arteriosus (PDA) adalah penyakit jantung kongenital akibat gagalnya ductus arteriosus untuk menutup segera setelah lahir. PDA dapat menyebabkan gangguan hemodinamika pada bayi prematur, serta meningkatkan morbiditas dan mortalitas sehingga perlu segera ditutup. Penutupan PDA dapat menggunakan ibuprofen sebagai penghambat cyclo oxygenase (COX), namun terdapat efek samping potensial yang ditimbulkan. Parasetamol dapat digunakan sebagai alternatif yang bekerja menghambat peroksidase (POX) dengan sedikit efek samping. Penelitian ini bertujuan untuk membandingkan efikasi parasetamol dan ibuprofen untuk penutupan PDA pada bayi prematur. Penelitian ini berbentuk literature review, menggunakan empat database yaitu Pubmed, ClinicalKey, Cochrane dan ScienceDirect. Kata kunci yang digunakan yaitu paracetamol AND ibuprofen AND patent ductus arteriosus AND preterm AND newborn. Hasil seleksi dengan kriteria inklusi dan eksklusi mendapatkan 13 literatur. Hasil penelitian mendapatkan bahwa parasetamol sama efektif dengan ibuprofen untuk terapi penutupan PDA pada bayi prematur. Parasetamol lebih aman dibandingkan ibuprofen akibat efek samping yang ditimbulkan. Simpulan penelitian ini ialah parasetamol sama efektif dengan ibuprofen serta lebih aman untuk digunakan sebagai terapi penutupan PDA pada bayi prematur.Kata kunci: parasetamol; ibuprofen; patent ductus arteriosus; prematur; bayi
First Experience of Patent Ductus Arteriosus Stenting in Neonate with Pulmonary Atresia and Intact Ventricular Septum in North Sulawesi, Indonesia David S. Waworuntu; Claresta Claresta
e-CliniC Vol. 11 No. 2 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i2.46960

Abstract

Abstract: Stenting of patent ductus arteriosus (PDA) is a minimally invasive catheter-based temporary palliative procedure, and it serves as an alternative to surgical shunt in neonates with duct dependent pulmonary perfusion, such as pulmonary atresia. This presentation aimed to report the first experience of PDA stenting in a neonate with pulmonary atresia in North Sulawesi, Indonesia. We reported a female neonate patient, weighing 3775 grams, referred from primary hospital with suspect congenital heart disease. The patient was born at 40 weeks of gestational age by caesarean section delivery from a primigravid mother aged 23 years with inertia uteri and strangulation of nuchal cord. At birth, she cried immediately and her APGAR score was 6-7. On her first day of life, she looked cyanotic, therefore she was referred to Prof. Dr. R. D. Kandou Hospital. Physical examination showed that she had perioral cyanotic and peripheral cyanotic with SpO2 58%. Chest X-ray showed cardiomegaly. Echocardiography revealed pulmonary atresia with PDA with intact ventricular septum. PDA stenting was done on her second day of admission. After the procedure, she was clinically stable with SpO2 80%, and was treated with intravenous antibiotic, and intravenous heparin and aspirin enterally. On the third day post procedure, she was discharged and no complication was found. PDA stenting in patient with duct-dependent pulmonary circulation appeared to be an alternative to surgery. It provided bridging palliation until the time of definitive surgery. The effectiveness of the procedure was highlighted by the fact that all the patients showed significant improvement in arterial saturation and pulmonary vascular marking. In conclusion, PDA stenting is considered feasible, safe and associated with lower mortality rates and shorter hospital length of stay than systemic-pulmonary surgical shunt procedure. Early detection and timely management are imperative to save the life. Keywords: patent ductus arteriosus stenting; pulmonary atresia
Co-Authors Alviolita P. Rondonuwu Claresta Claresta Johnny L. Rompis