Oral ibuprofen for patent ductus arteriosus in very low birth weight infants and its correlation with cerebral hemorrhage

ObjectiveTo explore the relationship between oral ibuprofen in the treatment of patent ductus arteriosus(PDA) and cerebral hemorrhage in very low birth weight infants.

MethodsNinety very low birth weight infants with PDA were selected as the research objects.According to the treatment plan, they were divided into study group and control group, with 45 cases in each group.Indomethacin was taken orally in the control group and ibuprofen was taken in the study group.The curative effect, incidence of cerebral hemorrhage and cardiac functionleft ventricular ejection fraction(LVEF), left ventricular end diastolic volume(LVEDV), left ventricular end systolic diameter(LVESD), cerebral hemodynamic parametersend-diastolic flow velocity(Vd) and resistance index(RI) of the anterior cerebral artery(ACA) and the middle artery(MCA) before and after treatment in the two groups were counted.Logistic analysis was used to analyze the risk of cerebral hemorrhage in very low birth weight infants with PDA.

ResultsThe total effective rate of treatment in the study group was 95.56%, and there was no significant difference compared with 91.11% in the control group(P>0.05).After treatment, the levels of LVEDV, LVESD and LVEF in the two groups were lower than those before treatment(P < 0.05), but there was no significant difference between the two groups(P>0.05);after treatment, the Vd of MCA and ACA in the study group was higher than that in the control group, and the RI was lower than that in the control group(P < 0.01);the incidence of cerebral hemorrhage in the study group was lower than that in the control group(P < 0.05);logistic regression analysis showed that long gestational age, high birth weight, high Apgar score at 1 minute of birth, and ibuprofen treatment were protective factors for cerebral hemorrhage in very low birth weight infants with PDA.Apnea, intrauterine distress, mechanical ventilation, maternal hemorrhage, and delayed labor were risk factors for cerebral hemorrhage in very low birth weight infants with PDA(P < 0.05 to P < 0.01).

ConclusionsOral ibuprofen is effective in the treatment of very low birth weight infants with PDA, which can improve ventricular remodeling, stabilize cerebral blood flow, and reduce the incidence of cerebral hemorrhage.In addition, cerebral hemorrhage in very low birth weight infants with PDA is related to various factors such as apnea, intrauterine distress, mechanical ventilation, etc., and craniocerebral ultrasound examination and dynamic observation should be actively performed to further reduce brain damage.