Intestinal perforations after enteral administration of indomethacin in premature infants

Kühl, G.; Seyberth, Hannsjörg W.

doi:10.1016/s0022-3476(86)81017-4

Cited by 5 publications

(6 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Indomethacin reduces renal artery blood flow velocity shortly after administration in preterm infants [1]. Indomethacin is associated with an increased incidence of intestinal bleeding and perforations in the preterm infant [41][42][43][44][45]. Coombs et al [2] and Van Bel et al [3] noted a significant reduction in superior mesenteric artery blood flow velocity in preterm infants receiving indomethacin.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 1999

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

et al. 1999

View full text Add to dashboard Cite

show abstract

“…60,61 Enteral administration is the most studied alternative to the IV formulation. In 1979, Cooke 62 reported an inadequate response to oral indomethacin provided at 0.2 mg/kg/dose every 12 hours for 3 doses; 5 of the 7 treated infants had no clinical response.…”

Section: Treatment Of Hspdamentioning

confidence: 99%

“…The investigators speculated that perhaps their findings were related to a locally induced prostaglandin deficiency resulting in less cytoprotection in the gastrointestinal tract. Kuhl and Sey-berth 60 hypothesized that the gastrointestinal side effects are not a local effect caused by oral administration, but rather decreased gut perfusion caused by the PDA, coupled with the blockage of mucosal vasodilation and integrity normally provided by prostaglandins. Similar findings were reported in a single case report in a letter to the editor in 1985 and by Nagaraj 61 in 1981 in which 8 of 82 infants given enteral indomethacin developed a focal perforation in various locations in the gastrointestinal tract.…”

Section: Treatment Of Hspdamentioning

confidence: 99%

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

Johnston

Gillam-Krakauer

Fuller

et al. 2012

Clinics in Perinatology

View full text Add to dashboard Cite

“…[6][7][8][9][10] Although it can be difficult to distinguish SIP from necrotizing enterocolitis (NEC) based on clinical presentation, the distinct histopathology [11][12][13][14] of an isolated or focal perforation makes SIP recognizable as a disease process separate from NEC. Widespread recognition of SIP began in the 1980's following the advent of indomethacin therapy for patent ductus arteriosus closure, [15][16][17][18] but the exact etiology remains unknown to date. Well-known risk factors for SIP include extreme prematurity and the concurrent use of steroids and indomethacin in the early postnatal period.…”

Section: Introductionmentioning

confidence: 99%

Definitive peritoneal drainage in the extremely low birth weight infant with spontaneous intestinal perforation: predictors and hospital outcomes

Jakaitis

Bhatia

2015

J Perinatol

View full text Add to dashboard Cite

PD was definitive therapy for the majority of neonates included in this study who were referred for surgical evaluation of SIP. Our data point to trends in being able to identify infants with SIP who are at risk for salvage laparotomy following PD, and thus, adverse nutritional outcomes. Larger, prospective studies are needed to further evaluate this specific patient population and identify those patients who are likely to succeed with PD following the diagnosis of SIP.

show abstract

Intestinal perforations after enteral administration of indomethacin in premature infants

Cited by 5 publications

References 3 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

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

Definitive peritoneal drainage in the extremely low birth weight infant with spontaneous intestinal perforation: predictors and hospital outcomes

Contact Info

Product

Resources

About