A comparison of different dosing regimen of intravenous paracetamol for hemodynamically significant patent ductus arteriosus closure in premature neonates < 32 weeks: a prospective observational study

Objectives: To compare the efficacy of low vs conventional dose intravenous paracetamol in closure of hemodynamically significant patent ductus arteriosus. Study design: Preterm infants (< 32 weeks gestation) having echocardiographic evidence of hsPDA were given intravenous paracetamol at low dose (15mg/kg followed by 7.5 mg/kg 6 hourly) vs conventional dose (15 mg/kg 6 hourly) for five days. Results 56 infants (28 in each group) were enrolled. Ductal closure was achieved in 96% infants in the low dose group and 100% infants in the conventional group (p = 1.00). Secondary outcomes including ductal reopening, need for second course of medical treatment, duration of hospital stay, cumulative oxygen requirement, mortality and other morbidities were comparable in both the groups. Mean paracetamol levels in both the groups were comparable (P = 0.67). Conclusion Low dose paracetamol was found to be equally effective compared to conventional dose paracetamol in closure of hsPDA.