Individualized ibuprofen treatment using serial B-type natriuretic peptide measurement for symptomatic patent ductus arteriosus in very preterm infants

Jeonghee Shin, Eun Hee Lee, Jee Hyun Lee, Byung Min Choi, Young Sook Hong

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Purpose: Plasma level of B-type natriuretic peptide (BNP), an emerging, sensitive, and specific biomarker of hemodynamically significant patent ductus arteriosus (PDA), rapidly decreases in infants receiving cyclooxygenase inhibitors for ductal closure. We investigated the usefulness of serial BNP measurement as a guide for individual identification of early constrictive responses to ibuprofen in preterm infants with symptomatic PDA (sPDA). Methods: Before March 2010, the standard course of pharmacological treatment was initiated with indomethacin (or ibuprofen) and routinely followed by 2 additional doses at intervals of 24 hours. After April 2010, individualized pharmacological treatment was used, starting with the first dose of ibuprofen and withholding additional ibuprofen doses if the BNP concentration was <600 pg/mL and clinical symptoms of PDA improved. Results: The BNP-guided group received significantly fewer doses of ibuprofen than the standard group did during the first course of treatment and the entire study period. The need for further doses of cyclooxygenase inhibitors and for surgical ligation was not significantly different between the 2 groups. No significant differences were seen in clinical outcomes and/or complications related to sPDA and/or pharmacological treatment. Conclusion: Individualized BNP-guided pharmacological treatment may be used clinically to avoid unnecessary doses of cyclooxygenase inhibitors without increasing the ductal closure failure and the short-term morbidity related to sPDA.

Original languageEnglish
Pages (from-to)175-180
Number of pages6
JournalKorean Journal of Pediatrics
Issue number6
Publication statusPublished - 2017 Jun
Externally publishedYes

Bibliographical note

Funding Information:
We thank the physicians and nursing staff working in the NICU of Korea University Ansan Hospital for their enthusiastic support and cooperation.

Publisher Copyright:
© 2017 by The Korean Pediatric Society.


  • B-type natriuretic peptide
  • Ibuprofen
  • Patent ductus arteriosus
  • Preterm infant

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pediatrics


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