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Effect of prophylactic indomethacin in extremely low birth weight infants

Korean Journal of Pediatrics 2006;49(9):959-965.
Published online September 15, 2006.
Effect of prophylactic indomethacin in extremely low birth weight infants
Bo Lyun Lee, Su Jin Kim, Soo Hyun Koo, Ga Won Jeon, Yun Sil Chang, Won Soon Park
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
초극소 저출생체중아에서 예방적 indomethacin 투여효과
이보련, 김수진, 구수현, 전가원, 장윤식, 박원순
성균관대학교 의과대학 삼성서울병원 소아과
Correspondence: 
Won Soon Park, Email: ws123.park@samsung.com
Abstract
Purpose
: The purpose of this study was to investigate the effect of prophylactic indomethacin on reduction of patent ductus arteriosus(PDA) and intraventricular hemorrhage(IVH) in extremely low birth weight infants(ELBWI).
Methods
: Retrospective review of 84 ELBWI who were admitted to our neonatal intensive care unit from June 2004 to April 2006 was performed. Patients were divided into prophylactic group(n=28) and control group(n=56), where prophylactic indomethacin were given within 6 hours after birth. Clinical outcomes were compared between these groups.
Results
: There were no significant differences in gestational age, birth weight, incidence of hemodynamically significant PDA and severe IVH, and mortality between prophylactic group and control group. However, there were more frequent indications for therapeutic indomethacin, higher incidence of intestinal perforation, and longer time to achieve full enteral feeding in prophylactic group than control group. The incidence of other adverse events attributed to indomethacin prophylaxis did not differ between two groups.
Conclusions
: Prophylactic indomethacin may not prevent hemodynamically significant PDA and severe IVH in ELBWI. On the contrary, it may be associated with increased risk of adverse events. Further efforts should be investigated to decrease PDA and severe IVH in ELBWI.
Key Words: Indomethacin, Intraventricular hemorrhage, Patent ductus arteriosus, Extremly low birth weight infant


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