Document Detail

Prolonged low-dose indomethacin therapy for patent ductus arteriosus in very low birthweight infants.
MedLine Citation:
PMID:  9069042     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine the efficacy and side-effects of prolonged low-dose indomethacin therapy in very low birthweight (VLBW; < 1500 g) infants with a haemodynamically significant patent ductus arteriosus (hsPDA). METHODOLOGY: Very low birthweight infants admitted over a 16 month period were studied (8 months, retrospectively and 10 months, prospectively). Cross-sectional and M-Mode echocardiograms with pulsed-wave and colour Doppler were performed to assess the significance of ductal patency. RESULTS: Forty-one (28%) of 148 VLBW infants were diagnosed to have hsPDA. Indomethacin therapy was successful in 90% after the first course, increasing to 95% after the second course. The recurrence rate after the first course was 3%. Minor and transient complications included oliguria, urea retention, hyponatraemia and thrombocytopenia. Although three infants had focal bowel perforation and the fourth had bowel perforation associated with necrotizing enterocolitis, the incidence of gastrointenstinal pathology was not significantly different from infants without hsPDA and not given indomethacin. CONCLUSIONS: Very low birthweight infants with hsPDA have a high response rate and low recurrence rate to prolonged low-dose indomethacin therapy. Side-effects were mild and transient. However, it is prudent to be cautious when administering indomethacin in critically ill infants < 1000 g with hsPDA who manifest clinical features of bowel ischaemia.
R K Kumar; V Y Yu
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of paediatrics and child health     Volume:  33     ISSN:  1034-4810     ISO Abbreviation:  J Paediatr Child Health     Publication Date:  1997 Feb 
Date Detail:
Created Date:  1997-05-07     Completed Date:  1997-05-07     Revised Date:  2007-09-24    
Medline Journal Info:
Nlm Unique ID:  9005421     Medline TA:  J Paediatr Child Health     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  38-41     Citation Subset:  IM    
Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
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MeSH Terms
Anti-Inflammatory Agents, Non-Steroidal / administration & dosage,  adverse effects,  therapeutic use
Drug Administration Schedule
Ductus Arteriosus, Patent / drug therapy*,  ultrasonography
Indomethacin / administration & dosage*,  adverse effects,  therapeutic use
Infant, Newborn
Infant, Very Low Birth Weight
Prospective Studies
Retrospective Studies
Survival Analysis
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 53-86-1/Indomethacin

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