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[Pharmacological closure of symptomatic PDA in premature infants using indomethacin]
1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
Insights
Symptomatic patent ductus arteriosus (PDA) in premature infants increases morbidity and mortality. Indomethacin treatment, whether in powder or liquid form, demonstrates significant success rates for ductal closure in these vulnerable infants.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Pharmacology
Abstract:
When left to right shunting through the ductus arteriosus is of a degree contributing to the cardiopulmonary problems in a premature infant, the condition is clinically termed symptomatic PDA. It is also generally agreed that symptomatic PDA if left untreated is a significant cause of increased morbidity and mortality. Studies have also concluded that all infants with symptomatic PDA who are prematurely born and/or ventilator dependent should be considered candidates for ductal closure by either pharmacological or surgical mean. Over a period of approximately 2 1/2 years, 22 premature infants with symptomatic PDA have been treated here with powder form indomethacin. The one course success rate was 68%. Thereafter, in another 2 1/2 years, 33 cases were selected for whom a liquid form was used instead. The success rate was 70%. Indomethacin is better given by an intravenous route. However, if the intravenous form is not available, using the liquid form by mouth or via the naso-gastric tube is a good substitute.