Publicado

2019-04-01

Tratamiento farmacológico del conducto arterioso permeable en recién nacidos prematuros

Pharmacological treatment of patent ductus arteriosus in premature infants

Palabras clave:

Conducto arterioso permeable, Terapéutica, Indometacina, Ibuprofeno, Acetaminofén (es)
Ductus Arteriosus Patent, Therapeutics, Indomethacin, Ibuprofen, Acetaminophen, Anti-inflammatory agents non-steroidal (en)

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Autores/as

  • Hellmann Adrián Escobar Hospital Universitario San José - Servicio de Urgencias
  • Gyhill Meneses-Gaviria Hospital Universitario San José - Servicio de Urgencias
  • Nataly Revelo-Jurado Universidad Libre - Facultad de Ciencias de La Salud - Programa de Medicina
  • Julián Felipe Villa-Rosero Hospital Universitario San José - Servicio de Urgencias
  • Jhon Edison Ijají Piamba Hospital Universitario San José - Servicio de Urgencias
  • Alexander Burbano-Imbachí Hospital Universitario San José - Servicio de Urgencias
  • Anuar Alonso Cedeño-Burbano Universidad del Cauca - Facultad de Ciencias de la Salud - Departamento de Anestesiología - Programa de Especialización en Anestesiología

Introducción. Por lo general, el manejo farmacológico del conducto arterioso permeable (CAP) comprende inhibidores no selectivos de la enzima ciclooxigenasa, en especial indometacina e ibuprofeno. En años recientes también se ha sugerido al acetaminofén como alternativa terapéutica.

Objetivo. Realizar una revisión narrativa de la literatura acerca del manejo farmacológico del CAP.

Materiales y métodos. Se realizó una búsqueda estructurada de la literatura en las bases de datos ProQuest, EBSCO, ScienceDirect, PubMed, LILACS, Embase, Trip Database, SciELO y Cochrane Library con los términos “Ductus Arteriosus, patent AND therapeutics”; “Ductus Arteriosus, patent AND indometacin”; “Ductus Arteriosus, Patent AND ibuprofen”, y “Ductus Arteriosus, patent AND acetaminophen”. La búsqueda se hizo en inglés con sus equivalentes en español.

Resultados. Se encontraron 69 artículos con información relevante para llevar a cabo la presente revisión.

Conclusiones. En neonatos prematuros, la base del tratamiento farmacológico del CAP continúa siendo los inhibidores no selectivos de la ciclooxigenasa, indometacina e ibuprofeno, ambos con perfiles similares de seguridad y eficacia. La evidencia disponible sugiere que el acetaminofén podría constituir una alternativa útil para el manejo, pero resulta insuficiente para realizar recomendaciones definitivas respecto a la eficacia y seguridad de este medicamento.

Introduction: Pharmacological management of patent ductus arteriosus (PDA) usually includes non-selective inhibitors of the enzyme cyclooxygenase, especially indomethacin and ibuprofen. Recently, acetaminophen has also been suggested as a therapeutic alternative.

Objective: To conduct a narrative review of the literature on pharmacological management of PDA.

Materials and methods: Structured literature search conducted on the ProQuest, EBSCO, ScienceDirect, PubMed, LILACS, Embase, Trip Database, SciELO and Cochrane Library databases, with the terms “Ductus Arteriosus, patent AND therapeutics”; “Ductus Arteriosus, patent AND indometacin”; “Ductus Arteriosus, Patent AND ibuprofen”, and “Ductus Arteriosus, patent AND acetaminophen”, and their equivalents in Spanish.

Results: 69 articles had relevant information to carry out the present review.

Conclusions: In premature infants, the mainstay of pharmacological treatment for PDA continues to be non-selective cyclooxygenase inhibitors, indomethacin and ibuprofen, all with similar safety and efficacy profiles. The available evidence suggests that acetaminophen may be a useful alternative for management, but it is insufficient to make definitive recommendations regarding the efficacy and safety of this drug.

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