Document Detail


A survey on the treatment strategy of patent ductus arteriosus in very low-birth-weight infants.
MedLine Citation:
PMID:  9553290     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study is a retrospective analysis of the clinical data of 67 very low birth weight infants (VLBWI) with symptomatic patent ductus arteriosus (PDA); all were admitted to four neonatal intensive care units (NICU) from January 1, 1996 through December 31, 1996. The mean gestational age was 27.9 +/- 2.4 weeks, the mean birth weight was 1078 +/- 193 g. Fifty-six infants (83.6%) had RDS, and 53 infants (79%) received artificial surfactant. The NICU at a regional hospital used CVD score > or =3 as the sole criteria and the remaining three NICUs used color Doppler echocardiogram to confirm a symptomatic PDA and to treat it; sometimes LA/AO > or = 1.3 was used as the criteria for indomethacin treatment. Two of these three hospitals sometimes used the pulsed Doppler echocardiogram as well as color Doppler examination as the treatment criteria. Seven infants (10.5%) had contraindication for indomethacin treatment; four of them closed after conservative treatment, and another three were subjected to surgical ligation. Of the remaining 60 infants, 3 were treated with oral indomethacin and 57 were treated with intravenous indomethacin. The mean age when initial treatment given was 3.8 +/- 1.5 days (range, 8 hours approximately 20 days). Among them 10 (16.7%) were within 24 hours after birth, 25 (41.7%) were between 24 and 48 hours, and 25 (41.7%) were beyond 48 hours. The dosage of indomethacin was 0.2 mg/kg per dose intravenously every 12 to 24 hours for three doses as a full course, if not contraindicated. The mean dose of indomethacin was 2.8 +/- 1.5; 10 infants (16.7%) received 1 dose, 15 (25%) received 2 doses, 27 (45%) received 3 doses, 3 (5%) received 4 doses and 5 (8.3%) received 6 doses. Among them, 51 infants (85%) PDA closed (including 2 treated with oral indomethacin), 9 (15%) failed to close and 6 of them received surgical ligation (including 1 treated with oral indomethacin). The complications associated with indomethacin treatment were hypoglycemia (52%), decreased urine output (42%) and gastrointestinal hemorrhage (32%). The infants with RDS had an earlier mean age of initial treatment than non-RDS infants (3.3 +/- 2.5 vs. 7.6 +/- 5.6 days; p < 0.05), and also had a higher closure rate (89% vs. 57%; p < 0.05). There was a closure rate of 85% in this multicenter retrospective analysis. Even though the infants received only one or two doses, they still had a good chance of ductal closure (21/25, 84%). To minimize the complications associated with indomethacin treatment in VLBWI, the protocol of indomethacin treatment should be re-evaluated.
Authors:
B H Su; P S Hu; H W Huang; L Y Liu; P H Yang; M Billiet
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  Zhonghua Minguo xiao er ke yi xue hui za zhi [Journal]. Zhonghua Minguo xiao er ke yi xue hui     Volume:  39     ISSN:  0001-6578     ISO Abbreviation:  Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi     Publication Date:    1998 Jan-Feb
Date Detail:
Created Date:  1998-04-30     Completed Date:  1998-04-30     Revised Date:  2008-02-12    
Medline Journal Info:
Nlm Unique ID:  16210470R     Medline TA:  Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi     Country:  TAIWAN    
Other Details:
Languages:  eng     Pagination:  33-7     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, China Medical College Hospital, Taichung, Taiwan, R.O.C.
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MeSH Terms
Descriptor/Qualifier:
Ductus Arteriosus, Patent / drug therapy*
Female
Humans
Indomethacin / therapeutic use*
Infant
Infant, Very Low Birth Weight*
Male
Retrospective Studies
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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