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Related Experiment Videos

Indomethacin-induced early patent ductus arteriosus closure cannot be predicted by a decrease in pulse pressure.

Ronit Lubetzky1, Dror Mandel, Francis B Mimouni

  • 1Department of Neonatology, Lis Maternity Hospital, Tel Aviv-Sourasky Medical Center, Tel Aviv, Israel.

American Journal of Perinatology
|July 3, 2004
PubMed
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Indomethacin therapy for patent ductus arteriosus (PDA) in preterm infants did not significantly change pulse pressure after PDA closure. Blood pressures increased, but pulse pressure remained stable, contrary to expectations.

Area of Science:

  • Neonatal physiology
  • Pediatric cardiology
  • Pharmacology

Background:

  • Wide pulse pressure is a recognized indicator of patent ductus arteriosus (PDA).
  • Early closure of PDA is a clinical goal in preterm infants.
  • The hemodynamic impact of PDA closure on pulse pressure requires further elucidation.

Purpose of the Study:

  • To investigate the effect of indomethacin therapy on pulse pressure in preterm infants with PDA.
  • To test the hypothesis that PDA closure leads to a significant decrease in pulse pressure.

Main Methods:

  • Echocardiographic diagnosis of PDA in 32 ventilated preterm infants within 24 hours of birth.
  • Measurement of systolic, diastolic, and mean arterial blood pressures before and after indomethacin treatment.

Related Experiment Videos

  • Confirmation of PDA closure via echocardiography.

    • Main Results:

    • Following PDA closure, significant increases in systolic, diastolic, and mean arterial blood pressures were observed.
    • Pulse pressure did not show a significant change after PDA closure (17 +/- 7 to 20 +/- 12 torr).

    Conclusions:

    • In preterm infants, indomethacin-induced PDA closure leads to increased blood pressures but does not significantly alter pulse pressure.
    • High early pulmonary resistance may limit diastolic aortic runoff, thus stabilizing pulse pressure irrespective of PDA status or closure.