Prophylactic acetaminophen given within 12 hours of birth in extremely preterm infants with patent ductus arteriosus (PDA) failed to improve survival without major morbidity. The study noted higher rates of premature PDA closure despite this treatment. It is a multinational randomized study. The treatment did not improve the overall health of the children. The main finding is the ineffectiveness of prophylactic acetaminophen in preventing serious complications. The results show the limits of this strategy in extreme prematurity.