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This discussion features Dr. Clyde Wright, Professor of Pediatrics at Children’s Hospital Colorado and the University of Colorado School of Medicine, who studies perinatal innate immunity and neonatal lung injury. He highlights the rapid rise of acetaminophen as the most commonly used medication for ductal closure in preterm infants despite limited long-term safety data. Dr. Wright explains how acetaminophen metabolism via CYP2E1 produces a reactive metabolite that may affect mitochondrial function in developing lung cells, prompting consideration beyond hepatic toxicity markers. He encourages clinicians to remain judicious, especially outside optimal treatment windows, and calls for research incorporating respiratory outcomes and nuanced, individualized risk–benefit discussions at the bedside.

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