DOES EARLY FLUID INTAKE INFLUENCE THE INCIDENCE OF PATENT DUCTUS ARTERIOSUS AFTER PROPHYLACTIC IBUPROFEN ADMINISTRATION

Background Evidence exists to suggest that fluid balance during the first days of life is an important risk factor for patent ductus arteriosus (PDA). Objective To determine if the fluid intake during the first 3 days of life influences PDA incidence in preterm neonates treated with prophylactic ibuprofen. Methods We examined fluid intake of the first 3 days of life in 200 neonates with gestational age ⩽28 weeks receiving ibuprofen prophylaxis (loading dose of 10 mg/kg, then two maintenance doses of 5 mg/kg at 24 h intervals). Echocardiographic evaluation was performed at birth and at 72 h of life. Fluid administration was daily individualised with reference to gestational age, weight changes and natraemia. Results After prophylaxis, 136 neonates (68%, group 1) showed closed ductus and 64 (32%, group 2) open ductus. Overall fluid intake during the first 3 days of life was similar between the groups (86.3 ± 12 vs 88.5 ± 14 ml/kg per day) without any significant difference at day of life 1 (69.5 ± 11 vs 69.7 ± 13 ml/kg), 2 (85.3 ± 16 vs 88.9 ± 17 ml/kg) and 3 (104.2 ± 19 vs 106.4 ± 19 ml/kg). Regression analysis did not identify the average fluid intake during the first 3 days of life as a significant risk factor for PDA (odds ratio (OR) 0.99; 95% CI 0.97 to 1.02). Conclusions Our study shows that fluid intake according to the present protocol does not increase the risk of PDA in prophylactically treated preterm neonates.