Effects of indomethacin and ibuprofen on mesenteric and renal blood flow in preterm infants with patent ductus arteriosus☆,☆☆
Section snippets
PATIENTS AND METHODS
We studied a group of 17 preterm infants <33 weeks’ gestational age, who were receiving mechanical ventilation because of respiratory distress syndrome and had evidence of hemodynamically significant PDA on the second day of life. Infants were excluded if they had malformations, renal or gastrointestinal abnormalities, hypotension or hypertension, infection, anemia (hemoglobin <10 g/dL), polycythemia (venous hemoglobin >22 g/dL), platelet count <50,000/mm3, or intraventricular hemorrhage of
RESULTS
There were no significant differences in birth weight, gestational age, amount of feeding, or postnatal age at the start of therapy (Table).
Variables Indomethacin (n = 8) Ibuprofen (n = 9) P value Birth weight (g) 1277 ± 440 (630-1890) 1151 ± 426 (580-1810) NS Gestational age (wk) 29.5 ± 2.6 (26- 32) 29.1 ± 2.1 (26-32) NS Age at treatment (h) 33.2 ± 5.4 (26-42) 31.9 ± 4.5 (27-40) NS FIO
2 (%) 39.7 ± 8.8 (28-55) 38.5 ± 8.0 (29-54) NS MAP (cm H2O) 8.8 ± 1.3
DISCUSSION
Indomethacin has been the drug of choice for the treatment of PDA, but significant reductions in cerebral, mesenteric, and renal perfusion have been reported.6, 7, 8, 9, 10 A continuous infusion of indomethacin over 24 hours minimized the reduction of cerebral perfusion.4 More recently, ibuprofen was used with the same efficacy to close the duct and was associated with fewer side effects.14, 26, 27 In comparison with indomethacin, ibuprofen did not reduce cerebral BFV in preterm human infants.12
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Cited by (0)
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Reprint requests: Marco Pezzati, MD, Division of Neonatology, Careggi University Hospital, Viale Morgagni 85, 50134 Firenze, Italy.
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0022-3476/99/$8.00 + 0 9/21/102410