Document Detail

Necrotizing enterocolitis and gastrointestinal complications after indomethacin therapy and surgical ligation in premature infants with patent ductus arteriosus.
MedLine Citation:
PMID:  12774134     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Indomethacin is the most frequently used pharmacological agent for closure of a patent ductus arteriosus (PDA) in premature infants. However, reports of complications, particularly, necrotizing enterocolitis (NEC) and isolated gastrointestinal perforation have generated concerns about the use of this medication. OBJECTIVES: A retrospective study to compare the incidence of NEC, NEC-related gastrointestinal complications and isolated gastrointestinal perforation among premature infants treated for a PDA with either, indomethacin alone (I), surgical ligation alone (L), or indomethacin followed by surgical ligation (I-L). METHODS: The medical records of 224 infants that underwent treatment, either pharmacological or surgical, for a PDA, confirmed by echocardiography, over a 4-year period (1995 to 1998) were analyzed. Treatment history and gastrointestinal complications were reviewed. RESULTS: Of the 224 infants, 108 (48.2%) were treated with I, 50 (22.3%) by L, 66 (29.5%) with I-L. The clinical characteristics of the three treatment groups were similar and no differences in the incidence of NEC were observed between groups. NEC occurred in 14 (13%) of the I group, seven (14%) of the L group, and eight (12%) of the I-L group. The rate of NEC related gastrointestinal complications and isolated gastrointestinal perforation were also similar among groups. CONCLUSION: In this large retrospective study, indomethacin treatment for a significant PDA in premature infants was not associated with a greater risk for NEC or NEC-related gastrointestinal complications than surgical ligation.
Donough J O'Donovan; Arlina Baetiong; Karen Adams; Ann Chen; E O'Brian Smith; James M Adams; Leonard E Weisman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  23     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-05-29     Completed Date:  2003-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  286-90     Citation Subset:  IM    
Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Houston, TX 77030, USA.
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MeSH Terms
Birth Weight
Cardiac Surgical Procedures / adverse effects*
Cardiovascular Agents / adverse effects*,  therapeutic use*
Ductus Arteriosus, Patent / drug therapy*,  surgery*
Enterocolitis, Necrotizing / etiology*
Gastrointestinal Diseases / etiology*
Gestational Age
Indomethacin / adverse effects*,  therapeutic use*
Infant, Newborn
Infant, Premature*
Intestinal Perforation / etiology*
Ligation / adverse effects
Retrospective Studies
Reg. No./Substance:
0/Cardiovascular Agents; 53-86-1/Indomethacin

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