Journal of the Korean Pediatric Society 1998;41(5):599-605.
Published online May 15, 1998.
Comparison of Continuous versus Intermittent Infusion of Indomethacin in PDA of Preterm Infants
Yun Kyoung Lee, Hee Seok Kim, Kyoung Ran Park, Chan Hu Park, June Dong Park, Beyong Il Kim, Woong Heum Kim, Jung Hwan Choi, Chong Ku Yun
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
미숙아 동맥관 개존증의 치료에서 인도메타신의 간헐적 정주와 연속 정주의 치료효과 및 부작용의 비교
이윤경, 김희석, 박경란, 박찬후, 박준동, 김병일, 김웅흠, 최중환, 윤종구
서울대학교 의과대학 소아과학교실
Abstract
Purpose
: Patent ductus arteriosus(PDA) of prematurity is very important disease to study because it causes many cases of perinatal morbidity and its incidence is now increasing. Nowadays indomethacin is the drug of choice for PDA closure, but its use has been limited due to its side effects. Therefore, we compared the effect and side effects of indomethacin according to the infusion method, continuous versus intermittent infusion, to find better an administration method.
Methods
: Twenty-five preterm infants who were admitted to Seoul National University Children's Hospital(SNUCH) NICU from March 1995 to August 1996 with a diagnosis of respiratory distress syndrome(RDS) and PDA, were enrolled. They were randomly assigned to intertmittent Ⅳ group or continuous Ⅳ group. Each group received three intermittent doses or continuous infusion over 36 hours, respectively. We analyzed the perinatal history, time of diagnosis and treatment of PDA, size of PDA, and compared the laboratory parameters, intraventricular hemorrhage(IVH), periventricular echogenecity(PVE), ductal closure and perinatal morbidity before and 48 hours after indomethacin administration between the two groups.
Results
: Fourteen infants(birth weight 1,149±373g) were intermittent Ⅳ group and eleven infants (birth weight 1,212±504g) were continuous Ⅳ group. There were no significant difference between the groups in perinatal history, pretreatment laboratory parameters, ductal closure, and perinatal morbidity. Patients with IVH of grade 2 or more increased significantly in intermittent Ⅳ group (50%) compared to continuous Ⅳ group(9%), and PVE progressed significantly in intermittent Ⅳ group(64%) compared to continuous Ⅳ group(18%).
Conclusion
: Continuous infusion of indomethacin for PDA closure in preterm infants with RDS appears to be as effective as intermittent infusion of indomethacin in closing PDA and have less side effects such as IVH and PVE progress.
Key Words: Indomethacin, Preterm infants, Patent ductus arteriosus


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