Introduction and objective: Patent ductus arteriosus is a heart defect primarily associated with extreme prematurity. It can lead to multiple morbidities due to diminished organ perfusion or a left-to-right shunt. It can be treated with paracetamol, among other options. Treatment includes fluid restriction, pharmacotherapy (paracetamol at a dose of 15 mg/kg, nonsteroidal anti-inflammatory drugs), percutaneous interventions, and surgical ligation. This retrospective study aims to analyse whether the analgesic dose of paracetamol and artificial ventilation has any effect on the occurrence of ductus arteriosus. Materials and methods: Ninety-four prematurely born neonates (<32 weeks of gestation) between 2020 and 2023 were included in the study. The dose of paracetamol, surfactant supply, and steroid therapy in the prenatal period were analysed up to the first echocardiographic examination. Additionally, data were collected about the type of ventilation during the examination. Logistic regression was used to evaluate predictive factors for PDA presence. Results: The median gestational age and weight were 30 weeks and 1290 g, respectively. Among 49 preterm neonates treated with intravenous paracetamol at an analgesic dose of ≤10 mg/kg, the risk of ductus arteriosus patency was lower (p = 0.002). Both non-invasive and mechanical ventilation increased the risk of ductus patency (p = 0.042, p = 0.044). There was no significant relationship between previous ductus and surfactant treatment or prenatal steroid use (p = 0.611, p = 0.93). Conclusions: Paracetamol in an analgesic dose reduces the likelihood of open ductus arteriosus in extremely and very premature infants. Additionally, artificial ventilation is a significant factor affecting ductus patency.

patent ductus arteriosus, paracetamol, non-invasive ventilation, mechanical ventilation, preterm infants