Effects of prophylactic ibuprofen on cerebral and renal hemodynamics in very preterm neonates

Objective: To evaluate the effects on cerebral and renal blood flow velocit ies of ibuprofen when used as prophylaxis for patent ductus arteriosus in p reterm neonates (gestational age less than or equal to 30 weeks). Methods: Blood flow velocities in the anterior cerebral artery and the rena l artery were measured with Doppler ultrasonography in 17 neonates before, during, and 10, 30, and 60 minutes after administration of 10 mg/kg ibuprof en lysine. Results: In four (23.6%) neonates without echocardiographic patency of the ductus, no significant modifications in blood flow velocities and Doppler i ndexes were found either in the anterior cerebral artery or in the renal ar tery. In 13 (76.4%) neonates, cardiac echocardiographic Doppler showed pate ncy of the ductus and left-to-right shunt. In these neonates diastolic and mean blood velocities rapidly increased both in the anterior cerebral arter y and the renal artery (P <.0001). Resistance and pulsatility index decreas ed during the study period (P <.0001 and P <.001, respectively, in the ante rior cerebral artery; P <.0001 in the renal artery). Conclusions: Data suggest that ibuprofen does not determine any direct effe ct on cerebral and renal blood flow velocities, hemodynamic modifications o bserved in neonates with patency of ductus can be related to closure of the ductus induced by the drug.