Pharmacologic Closure of Patent Ductus Arteriosus in the Premature Infant

Abstract

The prostaglandins affect smooth-muscle tone of the ductus arteriosus. Patent ductus often complicates the clinical course of prematurely born infants with respiratory-distress syndrome. In the present study, a single oral or rectal dose of a potent inhibitor of prostaglandin synthesis, indomethacin, was administered to six consecutive premature infants with the syndrome who would otherwise have undergone surgical ligation of the patent ductus. Within 24 hours all the clinical symptoms and physical, echocardiographic and radiographic signs attributable to substantial left-to-right shunting through a patent ductus arteriosus dramatically and permanently disappeared. A transient reduction in renal function was observed in two infants in whom sustained ill-effects did not occur. The observation that constriction and closure of the patent ductus arteriosus may be induced pharmacologically raises important possibilities for the improved treatment of the respiratory-distress syndrome.

Prolonged persistent patent ductus arteriosus: potential perdurable anomalies in premature infants

“…More than three decades after the first reports of medical treatment of the PDA, 47,48 management remains heterogeneous and controversial and ideal timing and criteria for various treatments remain still to be established. [49][50][51][52] Some authors have concluded that there is a need for new controlled, randomized trials to reexamine the benefits and risks of different approaches to PDA treatment 35,37 and others considered that clinical trials are needed to determine whether any interventions intended to close the PDA reduce mortality and morbidity rates.…”

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

“…Controlled and uncontrolled clinical trials showed that surgical ligation 24,25 and indomethacin 26,27 effectively achieve ductal closure. Describing a widespread impression, Kitterman commented.…”

The effect of intraamniotic thyroxine administration on fetal lung maturity in man

“…This infant was delivered by Caesarean section at 30 weeks because of severe toxemia and acute fetal distress. After intensive treatment which included administration of Indomethacin in order to close the patent ductus arteriosus (according to FRIEDMAN et al [5]), the infant made an uneventful recovery. It is quite difficult to explain the incidental RDS in case No.…”