DOI: https://doi.org/10.22141/2224-0551.3.54.2014.75997

Clinical Efficacy of Domestic Preparation of Ursodeoxycholic Acid in Comprehensive Treatment of Hyperbilirubinemia in Premature Infants

D.O. Dobryansky, L.V. Bonetska, I.O. Nosova, K.V. Orel, T.V. Telyegina, O.V. Bezpalko, Yu.Yu. Dubrovna, S.V. Protsyk, O.Ya. Detsik

Abstract


Several small pilot clinical studies suggest that the use of ursodeoxycholic acid (UDCA) may facilitate the course of neonatal jaundice. The aim of the work was to evaluate the clinical efficacy of Ukrliv® suspension in comprehensive treatment of hyperbilirubinemia in premature infants. In an open randomized study there were enrolled 35 preterm infants (19 — in the study, 16 — in the control group). Inclusion criteria were premature birth and hyperbilirubinemia (total serum bilirubin levels > 225 mmol/l) in the early neonatal period. Newborns in the study group, in addition to phototherapy, received Ukrliv® suspension in a daily dose of 20 mg/kg for 14 days. Formed groups did not differ in the main clinical characteristics and baseline concentrations of serum bilirubin. Children in both groups had a significant reduction in the initial concentrations of total serum bilirubin. During the first 3 days of treatment related dynamics was 44% in the study group versus 32% in the control one, ensuring the achievement of significant differences between the groups in the level of total and direct bilirubin at the time of completion of UDCA course. In infants from the study group jaundice was less prolonged. The drug was well tolerated by infants, no adverse effects of its use were revealed. Thus, the obtained results allow us to draw conclusions about the appropriateness of Ukrliv® suspension administration in comprehensive treatment of premature infants with hyperbilirubinemia.

References


Cashore W.J. Bilirubin and jaundice in the micropremie // Clin. Perinatol. — 2000. — V. 27. — P. 171-179.

Watchko J.F. Enduring controversies in the management of hyperbilirubinemia in preterm neonates / J.F. Watchko, M.J. Maisels // Seminars in Fetal & Neonatal Medicine. — 2010. — V. 15. — P. 136-140.

Maisels M.J. Treatment of jaundice in low birthweight infants / M.J. Maisels, J.F. Watchko // Arch. Dis. Child Fetal. Neonatal. Ed. — 2003. — V. 88. — P. 459-463.

Maisels M.J. Phototherapy — traditional and non-traditional // J. Perinatol. — 2001. — V. 21. — P. S93-S97.

Aggressive vs. conservative phototherapy for infants with extremely low birth weight / B.H. Morris, W. Oh, J.E. Tyson [et al.] // N. Engl. J. Med. — 2008. — V. 359. — P. 1885-1896.

American Academy of Pediatrics. Subcommittee on hyperbilirubinemia. Clinical practice guideline: management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation // Pediatrics. — 2004. — V. 114. — P. 297-316.

National Collaborating Centre for Women’s and Children’s Health. Neonatal jaundice. London (UK): National Institute for Health and Clinical Excellence (NICE); 2010 May. — 53 p. (Clinical guideline; no. 98)

Sugama S. Magnetic resonance imaging in three children with kernicterus / S. Sugama, A. Soeda, Y. Eto // Pediatr. Neurol. — 2001. — V. 25. — P. 328-331.

Kernicterus in preterm infants / A. Okumura, H. Kidokoro, H. Shoji [et al.] // Pediatrics. — 2009. — V. 123. — P. e1052-e1058.

Bhutani V.K., Johnson L.H., Shapiro S.M. Kernicterus in sick and preterm infants (1999–2002): a need for an effective preventive approach / V.K. Bhutani, L.H. Johnson, S.M. Shapiro // Semin. Perinatol. — 2004. — V. 28. — P. 319-325.

Serial brain MRI and ultrasound findings: relation to gestational age, bilirubin level, neonatal neurologic status and neurodevelopmental outcome in infants at risk of kernicterus / K. Gkoltsiou, M. Tzoufi, S. Counsell [et al.] // Early Hum. Dev. — 2008. — V. 84. — P. 829-838.

Parenteral nutrition-associated cholestasis in preterm neonates: evaluation of ursodeoxycholic acid treatment / A. Levine, A. Maayan, R. Shamir [et al.] // J. Pediatr. Endocrinol. Metab. — 1999. — V. 12. — P. 549-553.

Ursodeoxycholic acid (UDCA) therapy in very-low-birth-weight infants with parenteral nutrition associated cholestasis / C.Y. Chen, P.N. Tsao, H.L. Chen [et al.] // J. Pediatr. — 2004. — V. 145. — P. 317-321.

A controlled trial of erythromycin and UDCA in premature infants during parenteral nutrition in minimizing feeding intolerance and liver function abnormalities / T. Gokmen, S.S. Oguz, S. Bozdag [et al.] // J. Perinatol. — 2012. — V. 32. — P. 123-128.

Ursodeoxycholic acid treatment in preterm infants: a pilot study for the prevention of cholestasis associated with total parenteral nutrition / S. Arslanoglu, G.E. Moro, H.-D. Tauschel, G. Boehm // J. Pediatric Gastroenterol. and Nutrition. — 2008. — V. 46. — P. 228-231.

Rodrigues C.M.P. The therapeutic effects of ursodeoxycholic acid as an anti-apoptotic agent / C.M.P. Rodrigues, C.J. Steer // Expert Opin. Invest. Drugs. — 2001. — V. 10. — P. 1243-1253.




Copyright (c) 2016 CHILD`S HEALTH

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2018

 

   Seo анализ сайта