November 2015

Oral paracetamol or oral ibuprofen to close the ductus arteriosus: both “work,” but do we know when to use them?

Patent Ductus Arteriosus PDA is a common and severe morbidity among preterm neonates, and current treatment options are limited. This randomized controlled trial assessed the effectiveness of paracetamol in inducing closure of a hemodynamically significant PDA as compared to ibuprofen. The investigators concluded that paracetamol was equally as effective as ibuprofen for PDA closure; however, given the power of the study is limited by the size of trial, significant further study is necessary to determine the true efficacy and safety of paracetamol as a treatment for PDA.

Permissive hypercapnia in extremely-low-birthweight infants: how far should we go?

Bronchopulmonary Dysplasia Permissive hypercapnia has been proposed as a way to limit ventilator-induced lung injury and prevent the development of BPD in preterm neonates. This randomized controlled trial assessed whether targeting higher PaCO2 in the first 14 days of life would prevent BPD in ELBW infants. Interim analysis revealed no benefit to permissive hypercapnia, and this study was stopped early (~20% of planned recruitment). Further study is needed to define the role of permissive hypercapnia in the NICU.