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Published on: December 23, 2022
Usefulness of indomethacin for patent ductus arteriosus in full-term infants
Takeshi Takami1, Hitoshi Yoda, Tadashi Kawakami
1Department of Pediatrics, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, 160-0023 Shinjuku-ku, Tokyo, Japan. takami@tokyo-med.ac.jp
Insights
Indomethacin effectively treats patent ductus arteriosus (PDA) in full-term infants, with 61% responding to treatment. This medical option is viable before surgery for symptomatic PDA.
Area of Science:
- Neonatalogy
- Pediatric Cardiology
- Pharmacology
Background:
- Patent ductus arteriosus (PDA) is a common condition in neonates.
- While typically managed in premature infants, PDA can also affect full-term infants.
- Effective medical management options for PDA in full-term infants are crucial.
Purpose of the Study:
- To evaluate the effectiveness of indomethacin therapy for PDA in full-term infants.
- To assess the response rate and clinical improvement in this specific population.
- To determine if indomethacin is a suitable medical treatment prior to surgical intervention.
Main Methods:
- Retrospective study of 41 full-term infants (birth weight >= 2500g, gestational age >= 37 weeks) with PDA.
- Indomethacin administered intravenously (0.2-0.25 mg/kg/dose) within 23 days of birth.
- Echocardiographic evaluation and clinical assessment to determine treatment response.
Main Results:
- 61% of infants (25 out of 41) responded to indomethacin therapy (12 complete closure, 13 improved symptoms).
- No significant differences were found between responders and non-responders regarding gestational age, birth weight, or pre-treatment PDA characteristics.
- No severe adverse reactions to indomethacin were reported.
Conclusions:
- Indomethacin therapy is an effective medical treatment for symptomatic PDA in full-term infants.
- The treatment shows a favorable response rate and safety profile in this population.
- Indomethacin should be considered as a therapeutic option before surgical management of PDA in full-term infants.
Abstract:
The aim of this retrospective study was to evaluate the effectiveness of indomethacin therapy for patent ductus arteriosus (PDA) in full-term infants. The patients were 41 full-term infants with a PDA birth weight (BW) > or =2500 g and a gestational age (GA) > or =37 weeks. The echocardiographic evaluation and medical management of PDA in these infants was similar to that for PDA in low-birth-weight infants. Indomethacin (0.2-0.25 mg/kg/dose) was given intravenously at 12-24-hour intervals within 23 days of birth. Of the 41 infants, 12 showed complete closure, and 13 showed improvement of clinical symptoms. These 25 infants were classified as the responder group (61%). The other 16 infants, who did not show improvement in clinical symptoms, were classified as the nonresponder group. Statistical analysis revealed no difference between the two groups regarding GA, BW, Apgar score at 1 minute, minimum diameter of the DA before treatment, the average age at the initiation of treatment, and DA flow pattern. No severe adverse reactions were observed in any infant. Indomethacin therapy appears to be an effective medical treatment option for PDA in full-term symptomatic infants prior to considering surgical treatment.
