[Indomethacin and persistent ductus arterious in the pre-term newborn infant with respiratory insufficiency]

Forty-two cases of preterm infants with respiratory distress syndrome who developed congestive heart failure secondary to large arteriovenous shunt across permeable ductus arteriosus and who were treated with indomethacin are presented. The cases were divided into three groups according to birth weight: group I less than 1,200 g, group II between 1,250 and 2,000 g and group III from 2,000 to 2,500 g. Satisfactory results were obtained by either ductal closure or by important reduction in the left to right shunt with disappearance of the congestive failure in 37.5% of group 1, 71% in group II and 69% in group III. We concluded that indomethacin is the treatment of choice for patients weighing more than 1,050 g and over 30 weeks gestational age and that surgical ligation is the treatment of choice in patients under this weight and gestational age.