1563 Indomethacin (I) Therapy in Premature Infants With Pda — Determination of Therapeutic Plasma Levels

Yeh, TS; Achanti, B; Jain, Rashmi; Patel, Hemendra; Pildes, Rosita S.

doi:10.1203/00006450-198504000-01587

Cited by 3 publications

(2 citation statements)

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“…The plasma level at 12 h was 610 ng/ml and at 24 h was 490 ng/ml. Both were considered within the range of therapeutic level [11,12]. Ve and airway pressure generated during airway occlusion have been used to study respiratory center output in the young in fant.…”

Section: Resultsmentioning

confidence: 99%

Does Indomethacin Affect the Control of Breathing in Premature Infants?

Wilks²

1989

Dev Pharmacol Ther

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The effect of indomethacin on the control of breathing was simultaneously evaluated in 10 premature infants who had significant patent ductus arteriosus and received indomethacin therapy. In an attempt to maintain high plasma level in these infants of advanced postnatal age (≥ 6 weeks), indomethacin was administered intravenously at a dosage of 0.3 mg/kg, at 8-hour intervals, for a total of three doses. Following indomethacin therapy, there was a significant increase in tidal volume, minute ventilation, tidal volume/inspiratory time and in airway pressure (P(0.1), P(max)) generated during airway occlusion. Seven infants required lower ventilatory rates after study. In spite of desirable plasma indomethacin level, there was no significant improvement in echo left atrium/aortic root dimension ratio, cardiovascular dysfunction score and in blood pH, PO(2) and PCO(2). None of the infants showed clinical evidence of ductus closure. The results of the study suggested that indomethacin may stimulate respiration and that endogenous prostaglandin may play a role in the regulation of breathing.

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Section: Resultsmentioning

confidence: 99%

Does Indomethacin Affect the Control of Breathing in Premature Infants?

Wilks²

1989

Dev Pharmacol Ther

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“…When treating 8-10-day-old infants with left-to-right shunts that are causing cardiovascular compromise, the response of the ductus to indomethacin depends on the size of the dose (0.3 mg/kg vs. 0.1 mg/kg) (69), as well as on the number of doses administered (1 vs. 2 or 3) (69;70). Because drug clearance depends on postnatal age (9;12;60;63;68;69), one can envision that using the same indomethacin dosage regime recommended for infants at 8-10 days (when the half life of the drug is 21 hrs) (68;69) in infants who are treated on day 1 (when the half life is 71 hrs) (60) may lead to elevated and prolonged plasma concentrations.…”

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confidence: 99%

Persistent Patent Ductus Arteriosus

Clyman¹

1991

Int J Technol Assess Health Care

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Two observations about the ductus arteriosus are established: most normally developed infants will have a patent ductus arteriosus (PDA) at the time of delivery, and most fullterm infants will have anatomic obliteration of the ductus lumen by 3–6 months of age. Studies designed to determine how a PDA contributes to an infant's morbidity or when a PDA becomes a persistently patent ductus arteriosus have been hampered by the lack of consistent diagnostic criteria for defining the condition. Ellison et al. (22) attempted to evaluate several commonly used criteria for diagnosing a large leftto-right shunt through the ductus arteriosus by noting the occurrence of each sign both before and 36–48 hours after surgical ligation. No single criterion sufficed as an indicator of PDA. Certain signs, such as continuous murmur or hyperactive left ventricular impulse, were specific for a PDA, but lacked sensitivity; conversely, M-mode echocardiography and ventilatory support criteria were very sensitive but lacked specificity.

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