Effect of prolonged indomethacin therapy on renal function and selected vasoactive hormones in very-low-birth-weight infants with symptomatic patent ductus arteriosus

Seyberth, Hannsjörg W.; Rascher, Wolfgang; Hackenthal, Renate; Wille, L.

doi:10.1016/s0022-3476(83)80736-7

Cited by 119 publications

(38 citation statements)

References 22 publications

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“…Subsequently, numerous reports describing complications associated with its use in this popula-Speziale/Allen/Henderson/Barrington/ Finer tion were published. Transient renal dysfunction has been reported with the use of indomethacin in the preterm infant [37][38][39][40]. Indomethacin reduces renal artery blood flow velocity shortly after administration in preterm infants [1].…”

Section: Discussionmentioning

confidence: 99%

Effects of Ibuprofen and Indomethacin on the Regional Circulation in Newborn Piglets

et al. 1999

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We investigated the effects of clinically comparable doses of ibuprofen and indomethacin on renal, gastrointestinal and cerebral perfusion in newborn piglets, and hypothesized that ibuprofen would have less effect on regional circulation. Animals were randomly assigned to receive ibuprofen (20 mg/kg, n = 8), indomethacin (0.3 mg/kg, n = 7) or vehicle (n = 6). Fluorescent microspheres were injected prior to and at 20, 40, 60, 90 and 120 min after drug administration. Regional blood flow was measured and vascular resistances were calculated. Cardiovascular and respiratory variables were not significantly affected by either study drug or vehicle. Ibuprofen increased renal cortical and medullary resistance by 44 and 52% (p < 0.05). However, ibuprofen had no significant effects on gastrointestinal or cerebral resistance. Indomethacin raised renal cortical and medullary resistance by 66 and 71% at 60 min postinjection, respectively (p < 0.05). Indomethacin increased duodenojejunal, ileal and colon resistance by 97, 102 and 75% at 60 min, respectively (p < 0.05). Indomethacin increased cerebral cortical and cerebellar resistance by 92 and 86% at 90 min (p < 0.05). While indomethacin and, to a lesser extent, ibuprofen both increase renal vascular resistance, indomethacin vasoconstricts the gastrointestinal and cerebral circulations which are unaffected by ibuprofen.

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Section: Discussionmentioning

confidence: 99%

Effects of Ibuprofen and Indomethacin on the Regional Circulation in Newborn Piglets

et al. 1999

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“…Transient alterations in renal function and urine excretion are common problems with the initial doses of indomethacin (this appears to be less of a problem with ibuprofen). These renal abnormalities return to normal after the initial doses of indomethacin or with drug discontinuation (21). Indomethacin, by itself, does not appear to increase the incidence of other neonatal morbidities (e.g., necrotizing enterocolitis, gastrointestinal perforation, ROP, chronic lung disease (CLD), or cerebral white matter injury) (9)).…”

Section: Retinopathy Of Prematurity (Rop)mentioning

confidence: 99%

Patent Ductus Arteriosus: Evidence for and against Treatment

Clyman

Chorne

2007

The Journal of Pediatrics

139

103

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“…Though this approach looks appealing, side effects of indomethacin such as bleeding [5,6], decreased urine out put [6,7] and decreased cerebral blood flow [8] prohibit its systematic use. Identification of early predictors of symptomatic PDA (SPDA) may help to select those very pre term infants who will develop SPDA and to justify treatment before the occurrence of PDA symptomatology.…”

Section: Introductionmentioning

confidence: 99%

Pulsed Doppler Measurement of Left Ventricular Output as Early Predictor of Symptomatic Patent Ductus arteriosus in Very Preterm Infants

et al. 1989

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High left ventricular output (LVO) values are associated with symptomatic left-to-right ductal shunting in preterm infants. However, LVO data prior to the occurrence of symptomatic patent ductus arteriosus (SPDA) are lacking. To determine whether serial measurements could predict a SPDA, we measured LVO from day 1 until day 10 with pulsed Doppler echocardiography in 25 preterm infants with birth weights of less than 1,250 g and hematocrits of more than 0.40. Eleven infants never developed patent ductus arteriosus symptoms and had LVO values within the normal range (190–310 ml/min/kg) with only minimal daily variations. The remaining 14 infants developed SPDA which required treatment with indomethacin, ductal Hgation, or fluid restriction on days 2–5. From day 1 until day 5 their mean LVO values were significantly higher compared to the group without left-to-right ductal shunt and this increase was secondary to higher stroke volume values. An increase in LVO of more than 60 ml/min/kg consistently preceded SPDA by at least 24 h. Serial measurements of LVO using a single-pulsed Doppler approach can be used for early prediction of SPDA.

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Effect of prolonged indomethacin therapy on renal function and selected vasoactive hormones in very-low-birth-weight infants with symptomatic patent ductus arteriosus

Cited by 119 publications

References 22 publications

Effects of Ibuprofen and Indomethacin on the Regional Circulation in Newborn Piglets

Effects of Ibuprofen and Indomethacin on the Regional Circulation in Newborn Piglets

Patent Ductus Arteriosus: Evidence for and against Treatment

Pulsed Doppler Measurement of Left Ventricular Output as Early Predictor of Symptomatic Patent Ductus arteriosus in Very Preterm Infants

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