Paracetamol versus ibuprofen in the closure of patent ductus arteriosus: proportion and intervention comparison meta - analysis

Meta Analysis

Paracetamol versus Ibuprofen in the Closure of Patent Ductus Arteriosus: Proportion and Intervention Comparison Meta - Analysis

Jesmin Hossain¹, Mohammad Kamrul Hassan Shabuj².

¹Department of Pediatric Cardiology, National Heart Foundation Hospital and Research Institute, Mirpur, Dhaka, Bangladesh,
²Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

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Abstract
Background: Patent Ductus Arteriosus (PDA) is a common cause of neonatal morbidity. We aimed to do this meta-analysis to compare the efficacy of paracetamol/acetaminophen and ibuprofen for the closure of hemodynamically significant PDA (hsPDA) in preterm infants.
Method: Medline, Embase, Google scholar databases were searched for citations. We included 14 studies that had compared hsPDA closure in paracetamol group versus ibuprofen group in premature infants. Pooled proportion of hsPDA closures and odd’s ratio were analyzed.
Result: Pooled Odd’s ratio for intervention comparison meta-analysis was 1.20 (95% CI 0.85 to 1.70), signifying no difference of events of PDA closure in paracatamol group versus ibuprofen group and pooled proportion analysis of PDA closure with paracetamol was 77.8% (95%CI 73.76 to 81.49) in the fixed effect and 79.07% (95% 69.44 to 87.30) in random effect model . In the ibuprofen group pooled protion of PDA closure were 79% (95% CI 74.46 to 83.95) and 79.9 (95% CI 73.26 to 85.95) in fixed and random model respectively. Difference of proportion was 1.49% (95% CI, -4.65 to 7.44) (p=0.62).
Conclusison: Our study colcluded that closure of hsPDA in premature infants were comparable both in terms of intervention comparison metaanalysis and isolated proportion meta-analysis with paracetamol or ibuprofen.

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