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Effects of prophylactic indomethacin on renal and intestinal blood flows in premature infants

Kenichi Maruyama1, Tohru Fujiu

  • 1Department of Neonatology, Gunma Children's Medical Center, Gunma, Japan. maruken@gcmc.pref.gunma.jp

Pediatrics International : Official Journal of the Japan Pediatric Society
|February 22, 2012
PubMed

Insights

Prophylactic low-dose indomethacin increases diastolic blood flow in premature infants' renal and intestinal arteries. This effect is achieved by reducing ductal shunt volume without altering regional vascular resistance.

Area of Science:

  • Neonatalogy
  • Pharmacology
  • Pediatric Cardiology

Background:

  • Prophylactic indomethacin is used to prevent severe intraventricular hemorrhage and symptomatic patent ductus arteriosus in premature infants.
  • The impact of low-dose indomethacin on renal and intestinal blood flow in this population requires further investigation.

Purpose of the Study:

  • To investigate the effects of prophylactic low-dose indomethacin on renal and intestinal blood flow in extremely low-birthweight infants.
  • To assess changes in blood flow velocity and vascular resistance in the renal artery and superior mesenteric artery.

Main Methods:

  • A multicenter randomized control trial involving 19 extremely low-birthweight infants.
  • Infants were assigned to receive either low-dose indomethacin (0.1 mg/kg) or placebo.
  • Pulsed Doppler ultrasound was used to measure blood flow velocity in the right renal artery and superior mesenteric artery before and after the first dose.

Main Results:

  • End-diastolic blood flow velocity in the right renal artery and superior mesenteric artery significantly increased post-indomethacin administration.
  • Time-averaged mean blood flow velocity and relative vascular resistance did not change significantly in either artery.
  • A significant reduction in end-diastolic blood flow velocity was observed in the left pulmonary artery post-indomethacin.

Conclusions:

  • Prophylactic low-dose indomethacin enhances diastolic blood flow in the renal and superior mesenteric arteries.
  • This improvement in blood flow is attributed to a reduction in ductal shunt volume.
  • Regional vascular resistance remains unchanged, indicating a specific effect on diastolic flow dynamics.
Abstract

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