TY - JOUR
T1 - Acetaminophen serum concentrations in infants treated intravenously for patent ductus arteriosus
AU - McPherson, Christopher
AU - Luecke, Caitlyn M.
AU - Liviskie, Caren J.
AU - Zeller, Brandy N.
AU - Vesoulis, Zachary A.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - OBJECTIVE Although acetaminophen has emerged as a therapeutic option for treating hemodynamically significant patent ductus arteriosus (PDA) in preterm infants, limited data exist on pharmacodynamics. The objective of this research is to report serum acetaminophen concentrations at steady state in infants treated with intravenous acetaminophen for PDA and to examine associations with clinical outcomes. METHODS This retrospective study evaluated all infants admitted during the study period who received intravenous acetaminophen for the treatment of PDA. Acetaminophen dosing was 15 mg/kg every 6 hours. A serum acetaminophen concentration was obtained 4 hours after the eighth dose. Associations between serum concentrations and efficacy, assessed by ductal constriction on echocardiogram, and safety, assessed by serum creatinine and hepatic transaminases, were explored using simple linear regression. RESULTS A total of 36 infants were included, with a median birth weight of 720 g (IQR 585–895 g) and a median gestational age of 25 weeks (IQR 24–26 weeks). The median acetaminophen concentration in the cohort was 12.3 mg/L (IQR 6.7–16.5 mg/L; range, 1.1–29.0 mg/L). Serum acetaminophen concentrations did not correlate with infant demographics, hepatic transaminases during treatment, or duct size at treatment completion. We observed ductal closure across a wide range of serum acetaminophen concentrations. CONCLUSIONS We did not identify an association between acetaminophen serum concentrations following intravenous therapy and ductal response or hepatic toxicity.
AB - OBJECTIVE Although acetaminophen has emerged as a therapeutic option for treating hemodynamically significant patent ductus arteriosus (PDA) in preterm infants, limited data exist on pharmacodynamics. The objective of this research is to report serum acetaminophen concentrations at steady state in infants treated with intravenous acetaminophen for PDA and to examine associations with clinical outcomes. METHODS This retrospective study evaluated all infants admitted during the study period who received intravenous acetaminophen for the treatment of PDA. Acetaminophen dosing was 15 mg/kg every 6 hours. A serum acetaminophen concentration was obtained 4 hours after the eighth dose. Associations between serum concentrations and efficacy, assessed by ductal constriction on echocardiogram, and safety, assessed by serum creatinine and hepatic transaminases, were explored using simple linear regression. RESULTS A total of 36 infants were included, with a median birth weight of 720 g (IQR 585–895 g) and a median gestational age of 25 weeks (IQR 24–26 weeks). The median acetaminophen concentration in the cohort was 12.3 mg/L (IQR 6.7–16.5 mg/L; range, 1.1–29.0 mg/L). Serum acetaminophen concentrations did not correlate with infant demographics, hepatic transaminases during treatment, or duct size at treatment completion. We observed ductal closure across a wide range of serum acetaminophen concentrations. CONCLUSIONS We did not identify an association between acetaminophen serum concentrations following intravenous therapy and ductal response or hepatic toxicity.
KW - Acetaminophen
KW - Extremely low birth weight infant
KW - Neonatal intensive care
KW - Patent ductus arteriosus
KW - Pharmacology
UR - http://www.scopus.com/inward/record.url?scp=85067111783&partnerID=8YFLogxK
U2 - 10.5863/1551-6776-24.2.134
DO - 10.5863/1551-6776-24.2.134
M3 - Article
C2 - 31019406
AN - SCOPUS:85067111783
VL - 24
SP - 134
EP - 137
JO - Journal of Pediatric Pharmacology and Therapeutics
JF - Journal of Pediatric Pharmacology and Therapeutics
SN - 1551-6776
IS - 2
ER -