Date of Paper/Work

12-2011

Type of Paper/Work

Scholarly project

Degree Name

Master of Arts in Nursing

Department

Nursing

Advisor(s)

Gay Varecka

Abstract

A premature infant is at high risk for many complications and multiple morbidities. A patent ductus arteriosus (PDA) is just one complication that often presents with prematurity and can be a major cardiac defect creating variations of altered cardiac function and systemic circulation. The severity of effects a PDA can produce depends on factors such as gestational age of the infant, weight of the infant, size of the defect, and the overall health of the neonate.

This topic is significant in the medical field because infants born prematurely are seen to have a high rate of their patent ductus arteriosis (PDA) not closing after birth resulting in complications. When the PDA does not close, it produces left to right shunting of the blood in the heart. Left to right shunting is associated with pulmonary congestion and decreased blood flow to vital organs (Linder et al., 2010). Prior to the introduction of ibuprofen, the only alternative to indomethacin was a surgical ligation. This includes a thoracotomy with potentially serious complications including chylothorax, infections, respiratory compromise, and death, which is why this should be considered the last option (Sekar & Corff, 2008).

Ibuprofen was introduced as an alternative medication to close the PDA, but it is not being utilized in all institutions. The purpose of this project is to explore the use of ibuprofen as the first line of treatment for the closure of the PDA in the neonatal population. Information produced could aide in the development of a new standard of care in the neonatal intensive care units. Explanation of ibuprofens safety and efficacy as well as why it may be preferable to indomethacin will be supported.

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