Pharmacological closure of ductus arteriosus in preterm infants using indomethacin

Obeyesekere, H I; Pankhurst, S; Yu, V. Y. H.

doi:10.1136/adc.55.4.271

Cited by 31 publications

(9 citation statements)

References 19 publications

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“…Data on the incidence and significance of PDA in premature infants more than 2 weeks of age are limited and are either descriptive or analyzed as part of larger studies that predominantly include younger infants [3,4,7,9]. A consensus appears to have developed among pediatric cardiologists and neonatalogists that PDA, when detected in older premature infants, has different implications and importance, but this assumption is unproved.…”

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confidence: 97%

Ductus Arteriosus in Premature Infants Beyond the Second Week of Life

Carboni

Ringel

1997

Pediatr Cardiol

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Persistent patency of the ductus arteriosus (PDA), common in premature infants, is associated with severe respiratory distress. The likelihood and significance of finding PDA in premature infants beyond the second week of life is unknown. We retrospectively analyzed all echocardiograms obtained between 1987 and 1992 on infants <35 weeks' gestational age. Of 446 echocardiograms 77 were obtained from infants >/=14 days. Of the 77 infants, 17 (22%) were found to have PDA (group 1) and the remainder did not (group 2). Forty-eight infants had been diagnosed as having PDA prior to 14 days of age. Of these infants, 16 were from group 1. Thus only 1/17 (6%) infants diagnosed as having PDA after 2 weeks did not have a history of PDA. The presence of PDA after 2 weeks did not relate to duration of oxygen therapy, ventilator therapy, or hospital stay. Furthermore, late closure of PDA in a subgroup of 11 infants did not appear to affect these parameters. It was concluded that premature infants beyond the second week of life are unlikely to have PDA if PDA had not been diagnosed during the first 14 days. Closure of PDA beyond the second week may not improve the infant's respiratory status.

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confidence: 97%

Ductus Arteriosus in Premature Infants Beyond the Second Week of Life

Carboni

Ringel

1997

Pediatr Cardiol

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“…About 10% of premature infants with respiratory distress have a patent ductus arteriosus and signs of congestive heart failure [1], Indomethacin is frequently used in an attempt to pharmacologically close the ductus. The therapy failure rate varies greatly [2] and does not relate to varying blood levels [3].…”

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confidence: 99%

Interaction of Indomethacin with Adult Human Albumin and Neonatal Serum

Honoré¹,

Brodersen²,

Robertson³

1983

Dev Pharmacol Ther

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The binding of indomethacin to albumin was investigated at 37 °C, pH 7.4. The first stoichiometric binding constant is 2.5 X 10^5 M^-1. Indomethacin utilizes both the bilirubin and diazepam binding functions equally. The effect on bilirubin binding to albumin is negligible at therapeutic indomethacin blood levels. Oleic acid does not affect indomethacin binding until the oleate/albumin molar ratio exceeds 2. A method for measuring the reserve albumin equivalent for binding indomethacin is described. Measurement of this reserve binding equivalent in 33 neonatal serum samples shows no significant correlation of the reserve binding to the albumin level. This methodology may be useful in studying the variable response of infants with patent ductus arteriosus to indomethacin.

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“…Among our 16 patients, 11 were non responders. This high number could be due to the late administration of indomethacin in our material [14]. They all had a spontaneous closure of the ductus 2 to 4 weeks after indomethacin administration.…”

Section: Commentsmentioning

confidence: 77%

Retrolental fibroplasia in premature infants with patent ductus arteriosus treated with indomethacin

1982

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Abstract. Sixteen premature infants were treated with indomethacin, either orally or intravenously, in order to close a symptomatic patent ductus arteriosus requiring mechanical ventilation. Positive effect was obtained in 4 of the 10 orally treated patients and in 1 of the 6 with intravenous administration. Immediate side effects were impairment of renal function, abdominal distension, and restlessness.Although the oxygen administration was guided using a transcutaneous oxymonitor, three severe cases of retrolental fibroplasia occurred. As indomethacin is a nonselective inhibitor of all prostaglandins, it might also cause a constriction of the retinal arteries, and as such be a factor in the development of retrolental fibroplasia in small premature infants.

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Pharmacological closure of ductus arteriosus in preterm infants using indomethacin

Cited by 31 publications

References 19 publications

Ductus Arteriosus in Premature Infants Beyond the Second Week of Life

Ductus Arteriosus in Premature Infants Beyond the Second Week of Life

Interaction of Indomethacin with Adult Human Albumin and Neonatal Serum

Retrolental fibroplasia in premature infants with patent ductus arteriosus treated with indomethacin

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