Document Detail


Effect of indomethacin infused over 30 minutes on cerebral fractional tissue oxygen extraction in preterm newborns with a patent ductus arteriosus.
MedLine Citation:
PMID:  20389128     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A significant patent ductus arteriosus (PDA) is a common finding in the first days of life and, if persistent, is associated with an increased morbidity and mortality in the preterm newborn.
OBJECTIVES: Our aim was to investigate, using near-infrared spectroscopy, the effect of indomethacin on the fractional tissue (cerebral) oxygen extraction (FT(c)OE) in a group of preterm newborns undergoing medical treatment for a PDA.
METHODS: This is a prospective, observational study. A cohort of 18 preterm newborns (<32 weeks) undergoing treatment for a PDA with indomethacin were monitored continuously for mean arterial blood pressure, arterial oxygen saturation (SpO(2)) and regional cerebral oxygen saturation (r(c)SO(2)). Measurements were started 1 h before and continued for 4 h after the first indomethacin dose. A final measurement (1 h) was made within 24 h of completing the full course. FT(c)OE = [SpO(2) - r(c)SO(2)]/SpO(2) was then calculated. To analyze the data, we chose to average the measurements over 1-hour periods.
RESULTS: There was a significant increase in the FT(c)OE (0.06, 95% CI 0.04-0.09, p < 0.001) noticeable within the 1st hour after the start of indomethacin administration, which peaked in the 2nd hour (FT(c)OE increased by 0.08, 95% CI 0.04-0.11, p < 0.001) and lasted for the full 4-hour period measured.
CONCLUSION: Indomethacin, infused over 30 min, significantly increased the FT(c)OE in the preterm newborn, the effect lasting at least 4 h. This may represent a protective response to the indomethacin-induced reduction in cerebral blood flow demonstrated by others and warrants further investigation.
Authors:
Paul Keating; Elise Verhagen; Jacorina van Hoften; Henk ter Horst; Arend F Bos
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-04-13
Journal Detail:
Title:  Neonatology     Volume:  98     ISSN:  1661-7819     ISO Abbreviation:  Neonatology     Publication Date:  2010  
Date Detail:
Created Date:  2010-09-17     Completed Date:  2011-01-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101286577     Medline TA:  Neonatology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  232-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 S. Karger AG, Basel.
Affiliation:
Division of Neonatology, Department of Paediatrics, University Medical Centre Groningen, Groningen, The Netherlands. keatingp69@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents, Non-Steroidal / administration & dosage,  pharmacology
Cause of Death
Cerebrum / drug effects*,  metabolism
Ductus Arteriosus, Patent / drug therapy*,  metabolism,  mortality
Female
Humans
Indomethacin / administration & dosage*,  pharmacology*
Infant
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / drug therapy*,  metabolism,  mortality
Infusions, Intravenous
Male
Oxygen / analysis*,  metabolism
Oxygen Consumption / drug effects,  physiology
Spectroscopy, Near-Infrared
Time Factors
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 53-86-1/Indomethacin; 7782-44-7/Oxygen

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


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