Original ArticleDuration of Indomethacin Treatment of the Preterm Patent Ductus Arteriosus as Directed by Echocardiography
Section snippets
Methods
This study was conducted at a tertiary referral neonatal intensive care unit at Royal Prince Alfred Hospital, Sydney, Australia between 2003 and 2007. The study design was approved by the Human Research Ethics Committee of the Sydney South Area Health Service. Written informed parental consent was obtained before study commencement. Infants born before 30 weeks of gestational age (GA) and requiring respiratory support were eligible. In each infant, an echocardiogram was performed between 3 and
Results
We recruited 74 infants into the study between January 1, 2003 and June 30, 2007 (Figure 1; available at www.jpeds.com). Of 318 infants born before 30 weeks GA admitted to the nursery during this time period, 148 were eligible for the study, 138 either did not have a significant duct (< 2 mm) or had a closed duct, 72 were not approached, and 2 refused consent. During 2005, the study was suspended because there was no primary researcher on site. One infant was randomized to the standard treatment
Discussion
This study has shown that by tailoring the duration of indomethacin treatment to the ductal constrictive response 24hours after the first dose, it is possible to significantly reduce the exposure to the drug without affecting eventual successful closure rates. Empirically, this strategy for dose minimization would allow therapy for ductal closure to at a reduced risk of side effects. Our data are consistent with those reported by Su et al,6 who used the Doppler pattern of flow through the
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Cited by (0)
The authors declare no conflicts of interest.