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Indomethacin for closure of patent ductus arteriosus in prematures
Insights
Early administration of indomethacin effectively closes patent ductus arteriosus (PDA) in premature infants. This medication significantly reduced the need for surgical intervention compared to placebo.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Pharmacology
Background:
- Patent ductus arteriosus (PDA) is a common condition in premature infants.
- Symptomatic PDA can lead to significant morbidity and mortality.
- Effective non-surgical treatments are crucial for managing PDA in neonates.
Purpose of the Study:
- To evaluate the efficacy of indomethacin in closing PDA in premature infants.
- To compare the rate of surgical intervention for PDA between indomethacin and placebo groups.
Main Methods:
- A controlled, double-blind trial was conducted.
- Participants included premature infants with a birth weight < 1750 g and a murmur of PDA.
- Indomethacin (0.2 mg/kg twice orally, 24 hours apart) or placebo was administered.
Main Results:
- A significantly higher response rate was observed in the indomethacin group (12/24) compared to the placebo group (2/23) (p < 0.01).
- Fewer infants in the indomethacin group required subsequent surgical ligation for symptomatic PDA (4/24) versus the placebo group (13/23) (p < 0.01).
Conclusions:
- Early administration of indomethacin is moderately effective in closing PDA in premature infants.
- Indomethacin treatment reduces the need for surgical PDA closure in this population.
Abstract:
A controlled, double blind trial of indomethacin versus placebo was conducted in prematures of birth weight less than 1750 g, with a murmur of patent ductus arteriosus (PDA). The dose of indomethacin was 0.2 mg/kg for 2 doses, orally, 24 hours apart. Forty-seven patients entered the trial. Twenty-four received indomethacin and 12 of these met the criteria for response; 23 received the placebo and two met the criteria for response (p less than 0.01). Subsequent surgical ligation for symptomatic PDA was required in 13 of 23 in the placebo group and 4 of 24 in the indomethacin group (p less than 0.01). When administered early, indomethacin is moderately effective in closing PDA in premature infants.