Administration of indomethacin for the prevention of periventricular-intraventricular hemorrhage in high-risk neonates

Factors affecting successful closure of hemodynamically significant patent ductus arteriosus with indomethacin in extremely low birth weight infants

“…There is no good evidence that any of the strategies can result in a longterm benefi t, in particular, the morbidities of BPD, IVH and disability-free survival. [10][11][12][13] Conventional dose of indomethacin has shown to be effective in closing PDA in premature infants, but it could result in more severe side-effects. Prolonged administration of lowdose indomethacin (0.1 mg/kg daily for 6 days) is equally, but not more, effective than the conventional dose.…”

Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?

“…Indomethacin treatment of PDA (Figure 4c) is associated with a greater overall rate of IVH (one-tailed P<0.05; rates of IVH>grade 2 were not reported). In separate trials, mortality 97 and IVH 107 rates were greater among infants <1000 g who received indomethacin prophylaxis. Ment et al 91,98 found that prophylactic indomethacin was associated with the reduction in both IVH and PDA, but these effects were independent, and PDA closure did not affect progression of IVH to parenchymal involvement.…”

Evidence-Based Use of Indomethacin and Ibuprofen in the Neonatal Intensive Care Unit

“…113,151,153,154 Although there was initially conflicting evidence on the effectiveness of IVH prevention, especially in infants weighing less than 1000 g, 154,155 it was subsequently shown that prophylactic indomethacin (administered at <12 hours of age) was effective in reducing higher-grade IVH. In 1988, Bandstra and colleagues 113 randomized almost 200 infants born at less than 1300 g to either receive 3 doses of indomethacin starting within 12 hours of birth or placebo.…”