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- georgschmoelzer
- 8 minutes ago
- 2 min read
Closing the Gap: Improving Treatment for Patent Ductus Arteriosus in Tiny Preemies
Every heartbeat counts in the early days of life — especially for our tiniest babies.
The ductus arteriosus (DA) is a normal blood vessel in the fetus that connects the main artery of the heart (the pulmonary artery) to the aorta. This vessel allows blood to bypass the lungs before birth, since oxygen is supplied by the placenta. After birth, the DA naturally closes within 48 hours as the baby begins to breathe air.
However, in extremely premature infants—those weighing less than 1 kilogram—this vessel often remains open. When it doesn’t close, the condition is called Patent Ductus Arteriosus (PDA). PDA can cause significant complications, including bleeding in the brain or lungs, feeding problems, growth failure, and prolonged dependence on breathing machines. In some cases, it can even be life-threatening.
Why current treatments don’t always work
Doctors usually try to close a PDA using medications like ibuprofen or indomethacin. These drugs can be effective, but only in about half of cases after the first course of treatment. When the PDA remains open despite medication, babies often require surgery — which carries its own risks.
A new idea: combining two safe and familiar medicines
Recent studies suggest that acetaminophen (Tylenol) may also help close a PDA. Interestingly, it works through a different biological pathway than ibuprofen, meaning that using the two together could have a synergistic effect — each helping the other work more effectively.
In previous research, we found that babies who did not respond to ibuprofen alone often responded to Tylenol, allowing them to avoid surgery. This promising finding led us to design a new clinical trial to test the combined use of ibuprofen and Tylenol from the start.
What this study aims to discover
Our trial will compare two approaches in extremely low gestational age neonates (ELGANs):
Standard treatment: ibuprofen alone
New combination therapy: ibuprofen + acetaminophen (Tylenol)
We aim to determine whether the combination helps close the PDA more effectively and earlier, reducing the need for surgery and minimizing PDA-related complications.
Why this research matters
By finding safer and more effective ways to close PDA sooner, we hope to improve survival and long-term health outcomes for extremely premature infants. Every improvement in care can make a lasting difference — helping these fragile newborns start life with stronger hearts and healthier futures.
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