8. Interventions for symptomatic PDA: failure of PDA closure after completion of allocated treatment.
| Comparison | ||||
| Indomethacin | Ibuprofen | Placebo/no treatment | ||
| Therapy |
Indomethacin |
Continuous vs intermittent bolus* PDA closure day 2: 1.57, 95% CI 0.54 to 4.60; 2 RCTs, N = 48 PDA closure day 5: 2.77, 95% CI 0.33 to 23.14; (1 RCT, N = 25 |
‐ | 0.30, 95% CI 0.23 to 0.28; 10 RCTs, N = 654; high‐certainty evidence |
|
Prolonged vs short course* 0.82, 95% CI 0.51 to 1.33; 4 RCTs, N = 361 | ||||
| Ibuprofen |
Ibuprofen IV/PO vs indomethacin IV/PO* 1.07, 95% CI 0.92 to 1.24; 24 RCTs, N = 1590; moderate‐certainty evidence |
Ibuprofen PO vs ibuprofen IV* 0.38, 95% CI 0.26 to 0.56; 5 RCTs, N = 406; moderate‐certainty evidence |
Ibuprofen IV 0.62, 95% CI 0.44 to0.86; 2 RCTs, N = 206; moderate‐certainty evidence |
|
|
Ibuprofen high‐dose vs standard‐dose* 0.37, 95% CI 0.22 to 0.61; 3 RCTs, N = 190; moderate‐certainty evidence | ||||
|
Ibuprofen PO vs indomethacin IV/PO* 0.96, 95% CI 0.73 to 1.27;8 RCTs, N = 272; low‐certainty evidence |
Ibuprofen IV: echocardiography‐guided vs standard administration* 1.31, 95% CI 0.44 to 3.91; 1 RCT, N = 49 |
Ibuprofen PO 0.26, 95% CI 0.11 to 0.62; 1 RCT, N = 64 |
||
|
Ibuprofen IV: continuous infusion vs Intermittent bolus* 1.18, 95% CI 0.88 to 1.5; 1 RCT, N = 111 | ||||
|
Ibuprofen PR vs PO* 0.83, 95% CI 0.28 to 2.4; RCT, N = 72 | ||||
| Acetaminophen | 1.02, 95% CI 0.78 to 1.33; 4 RCTs, N = 380; low‐certainty evidence |
1.02, 95% CI 0.88 to 1.18; 18 RCTs, N = 1535; moderate‐certainty evidence |
Early treatment(< day 7) 0.35, 95% CI 0.23 to 0.53; 2 RCTs, N = 127; low‐certainty evidence |
|
|
Late treatment (≥ day 14) 0.85, 95% CI 0.72 to 1.01; 1 RCT, N = 55; low‐certainty evidence | ||||
| Ibuprofen + Acetaminophen | ‐ | 0.77, 95% CI 0.43 to 1.36; 2 RCTs, N = 111; low‐certainty evidence | ‐ | |
| Surgical Ligation | 0.04, 95% CI 0.01 to 0.27; 1 RCT, N = 154 | ‐ | ‐ | |
| Furosemide with indomethacin | 1.25, 95% CI 0.62 to 2.52; 3 RCTs, N = 70 | ‐ | ‐ | |
| Dopamine with indomethacin | 1.11, 95% CI 0.56 to 2.19; 3 RCTs, N = 74 | ‐ | ‐ | |
CI: confidence interval;IV: intravenous; PO: per os; PDA: patent ductus arteriosus; PR: per rectum; RCT: randomised controlled trials; vs: versus
Reference is the listed comparison, therapy unless otherwise indicated by *
Differences between intervention and comparison provided as risk ratio (RR), unless otherwise specified; certainty of evidence added when available from review.