Volume 50(6); June

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Korean Journal of Pediatrics 2007;50(6):531-535.
Published online June 15, 2007.
The factors associated with the efficacy of indomethacin treatment in premature infants with patent ductus arteriosus
Min Jeong Yoon1, Hye Sun Yoon2, Sung Hoon Chung1, Mi Young Han1, Chong Woo Bae3
1Department of Pediatrics, College of Medicine, Kyunghee University, Korea
2Department of Pediatrics, College of Medicine, Eulji University, Korea
3Department of Pediatrics, Kyunghee University East-West Neo-medical Center, Korea
인도메타신 투여 시 미숙아 동맥관개존 치료효과에 영향을 미치는 인자
윤민정1, 윤혜선2, 정성훈1, 한미영1, 배종우3
1경희대학교 의과대학 소아과학교실
2을지대학교 소아과학교실
3경희대학교 동서신의학병원 소아과학교실
Correspondence: 
Mi Young Han,Email: myhan44@hanmail.net
Abstract
Purpose
: Indomethacin treatment is successful in about 90% of patent ductus arteriosus (PDA) in premature infants, but in some, repeated administration or surgical closure is required. The object of the present study is to determine the factors affecting the efficacy of indomethacin treatment and to predict the treatment result. Method : The 29 preterm neonates, admitted to neonatal intensive care unit of Kyunghee university medical center and Eulji university hospital between September 2002 and April 2006 were diagnosed of PDA and treated with indomethacin. The risk factors that might affect the efficacy of treatment were studied retrospectively.
Results
: The single-administered group was 19 patients out of 29 (65.5%) and among the repeated- administered group, 5 patients (17.2%) had repeated indomethacin administration and the other 5 patients (17.2%) underwent surgery due to reopening of the duct after repeated medical treatment. In repeated-administered group, the diameter of PDA was significantly larger (3.66?.8 mm vs 2.55?.8 mm, P<0.01), especially when larger than 3.5 mm (sensitivity: 70%, specificity: 89%). Also, the mean postnatal age of the first indomethacin administration was significantly delayed in repeated- administered group (19.7 days vs 12.5 days, P<0.05). There were no significant differences in gestational age (32 wk 5 days vs 30 wk 8 days) and in birth weight (1598.9 g vs 1750.5 g). There were no significant differences in associated morbidities.
Conclusion
: In patients with larger diameter of PDA (>3.5 mm) and older postnatal age (>7 days), the effect of indomethacin was decreased. Therefore in such cases, repeated dose of indomethacin or surgical ligation should be considered earlier.
Key Words: Infant, Premature, Ductus Arteriosus, Patent, Indomethacin




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