| Indomethacin therapy in premature infants with patent ductus arteriosus. |
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Dug Ha Kim, Jung Hwan Choi, Chong Ku Yun |
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Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea |
| 미숙아 동맥관 개존증에 대한 인도메타신 치료에 관한 연구 |
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김덕하, 최중환, 윤종구 |
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서울대학교 의과대학 소아과학교실 |
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Received: 18 June 1991 • Accepted: 4 July 1991 |
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| Abstract |
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Patent ductus arteriosus (PDA) is a common disease that occurred in 20 〜 40 percent of premature
infants. The incidence of PDA is inversely related to the gestational age and birth weight.
Hemodynamically significant PDA increases the morbidity and mortality of premature infants. So,
the management of PDA is one of the major problems in neonatal intensive care unit.
Based on experimental animal studies, the use of indomethacin in an attempt to close the ductus
arteriosus was introduced in 1976. Since then several studies have been reported the effect of in-
domethacin on PDA of premature infant, but no study has been reported yet in Korea.
The purpose of this study was to examine the response of PDA to indomethacin as well as to
observe the complication of indomethacin.
From August 1985 to July 1990, indomethacin was given to 18 premature infants for the phar-
macological closure of symptomatic PDA in the neonatal intensive care unit (NICU) at Seoul
National Unversity Children’s Hospital. Significant PDA was diagnosed on the basis of clinical and
echocardiographic findings.
The results obtained were as follows:
1) The PDA initially closed in 12 (6.7%) of 18 infants. But in one (8.3%) of 12 infants responsive to
indomethacin, PDA reopened. Of 6 infants in whbm indomethacin therapy failed, 3 infants had
surgical ligation, in 2 infants PDA closed spontaneously and after 2nd cycle of indomethacin therapy
respectively.
2) 2 of 12 infants responsive to indomethacin therapy had maintenance indomethacin therapy for
prevention of reopeii and PDA kept closed.
3) Closure rates were not significantly related to gestational age, birth weight, Apgar score, sex,
presence of hyaline membrane disease but response was better in infants less than 7 days old than
those more than 7 days old (83.3% vs 33.3%, p <0.05).
4) Oliguria occurred in 2 infants (11.1%) and hyponatremia occurred in one (5.6%), but they
recoverd within 24 hours. Neither serum BUN, creatinine, sodium, nor potassium were altered
significantly before and after indomethacin administration. Urine output fell 1 day after indometh-
acin administration without statistical significance (64.7±20.6 ml/kg/day vs 57.0±17.4 ml/kg/day,
p>0.05).
We conclude that indomethacin has pharmacological effect on the closure of PDA in premature
infants without any significant side effects. |
| Key Words:
Indomethacin, Patent ductus arteriosus, Premature infants |
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