Uso de paracetamol para el tratamiento de la persistencia del conducto arterioso en Recién nacidos prematuros: Una revisión sistemática
DOI:
https://doi.org/10.33448/rsd-v11i14.36002Palabras clave:
Conducto arterioso permeable; Recién nacido prematuro; Tratamiento con fármacos; Acetaminofén.Resumen
Objetivo: La patencia del conducto arterioso se asocia con múltiples complicaciones y alta mortalidad neonatal. Este estudio tiene como objetivo evaluar la eficacia y los beneficios del uso de acetaminofén sobre ibuprofeno y indometacina, medicamentos antiinflamatorios no esteroideos generalmente utilizados para cerrar el conducto arterioso en prematuros. Fuente de datos: Se realizaron búsquedas en las bases PubMed, SciELO, Lilacs, Bireme, ClinicalTrials.gov y Embase considerando el período comprendido entre enero de 2005 y diciembre de 2020 y utilizando los descriptores Recién Nacido Prematuro, Conducto Arterioso Permeable, Tratamiento con Fármacos, Cerrarse, Acetaminofén/Paracetamol. La calidad de los artículos fue evaluada por la clasificación del Oxford Centre for Evidence based Medicine. Síntesis de datos: el Acetaminofén tiene una eficacia similar al ibuprofeno y la indometacina, con tasas más bajas de hemorragia gastrointestinal e intracraneal, perforación intestinal espontánea, trombocitopenia, intolerancia hepática y renal, y valores más bajos de urea sérica, creatinina y bilirrubina. El paracetamol demuestra ser más ventajoso que el placebo o la no intervención y puede ser la mejor opción terapéutica en casos de contraindicación a otros fármacos. Se ha observado que la edad gestacional y el peso al nacer influyeron en la eficacia del paracetamol, que tuvo un efecto menor en los recién nacidos extremadamente prematuros de extremadamente bajo y muy bajo peso al nacer. Conclusiones: Son necesarios más estudios clínicos que confirmen la indicación de paracetamol. Sin embargo, este demuestra ser una alternativa farmacológica prometedora, con una eficacia similar a los antiinflamatorios no esteroideos clásicos, con menores efectos adversos.
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Derechos de autor 2022 Mylvia David Chiaradia de Resende; Samuel Marques dos Reis; Gabriel Silvestre Minucci; Bruna Luiza Tavares Hernandes; Renata Corrêa Vasconcellos; Joel Alves Lamounier
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