Document Detail


Closure of the ductus arteriosus with indomethacin in ventilated neonates with respiratory distress syndrome. Effects of pulmonary compliance and ventilation.
MedLine Citation:
PMID:  1990934     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The reported effects of indomethacin on pulmonary compliance are variable depending upon the patient population and on the degree to which indomethacin resulted in successful ductal closure. Eleven fluid-restricted, furosemide-treated premature infants being mechanically ventilated for respiratory distress syndrome (RDS) who also had a significant patent ductus arteriosus (PDA) had pulmonary function testing performed before and after successful closure of the PDA. The diagnosis of a significant PDA was made by clinical and echocardiographic criteria. Indomethacin was administered at a dosage of 0.2 mg/kg/dose every 12 to 18 h for 1 to 3 doses. To control for the 48-h time interval to achieve ductal closure, nine premature infants being ventilated for RDS but who did not have a significant PDA also had pulmonary function evaluations performed before and after the 48 h. Also, to control for the independent effect of fluid restriction and diuretic therapy on pulmonary compliance, eight such premature infants with a PDA had pulmonary function evaluations performed at a 48-h interval. Successful closure of the ductus with indomethacin was associated with an improvement in compliance and ventilation parameters in all infants in the indomethacin-treated infants. In the indomethacin-treated group, the mean percent improvements were noted in the following parameters: CLdyn, 59.2%; CLI, 78.3%; CLE, 63.3%; VT, 63.3%; VE, 54.6%. There were no significant changes in the pulmonary functions in the 48-h RDS or the 48-h PDA fluid-restricted, furosemide-treated control groups. In conclusion, successful closure of the ductus with indomethacin causes a significant improvement in compliance and ventilation parameters in infants being mechanically ventilated for RDS.
Authors:
J L Stefano; S Abbasi; S A Pearlman; M L Spear; K L Esterly; V K Bhutani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American review of respiratory disease     Volume:  143     ISSN:  0003-0805     ISO Abbreviation:  Am. Rev. Respir. Dis.     Publication Date:  1991 Feb 
Date Detail:
Created Date:  1991-03-07     Completed Date:  1991-03-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370523     Medline TA:  Am Rev Respir Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  236-9     Citation Subset:  AIM; IM    
Affiliation:
Thomas Jefferson Medical College, Philadelphia, Pennsylvania.
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MeSH Terms
Descriptor/Qualifier:
Ductus Arteriosus, Patent / complications,  drug therapy*
Humans
Indomethacin / therapeutic use*
Infant
Infant, Newborn
Lung Compliance*
Respiration*
Respiration, Artificial*
Respiratory Distress Syndrome, Newborn / complications*,  physiopathology,  therapy
Chemical
Reg. No./Substance:
53-86-1/Indomethacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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