A controlled, double blind trial of indomethacin versus placebo was conducted in prematures of birth weight <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 < 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 < 0.01). When administered early, indomethacin is moderately effective in closing PDA in premature infants.
Get full access to this article
View all access options for this article.
References
1.
Cotton RB, Stahlman MT, Bender HW, et al: Randomized trial of early closure of symptomatic patent ductus arteriosus in small preterm infants. J Pediatr93:647, 1978
2.
Nestrud RM, Hill DE, Arrington RW, et al: Indomethacin treatment in patent ductus arteriosus. DevPharmacol Ther1:125, 1980
3.
Yanagi R., Wilson A., Fletcher MA, et al: Efficacy of Indocin (IN) for symptomatic (S) PDA: a double-blind controlled study. Pediatr Res12:392, 1978
4.
Neal WA, Kyle JM, Mullett MD: Failure of indomethacin therapy to induce closure of patent ductus arteriosus in premature infants with respiratory distress syndrome. J Pediatr91:621, 1977
5.
Merritt TA, DiSessa TG, Feldman BH, et al: Closure of patent ductus arteriosus with ligation and indomethacin: a consecutive experience. J Pediatr93:639, 1978
6.
Yeh TF, Luken JA, Thalji A., et al: Intravenous indomethacin therapy in premature infants with persistent ductus arteriosus—a double-blind controlled study. J Pediatr98:137, 1981
7.
Alpert BS, Lewins MJ, Rowland DW, et al: Plasma indomethacin levels in preterm newborns with symptomatic patent ductus arteriosus: clinical and echocardiographic assessments of response . J Pediatr95:578, 1979
8.
Bhat R., Vidyasagar D., Fisher E., et al: Pharmacokinetics of oral and intravenous indomethacin in preterm infants. DevPharmacol Ther1:101, 1980
9.
Bianchetti G. , Monin P., Marchal F., et al: Pharmacokinetics of indomethacin in the premature infant. DevPharmacol Ther1:111, 1980
10.
Thalji AA, Carr I., Yeh TF, et al: Pharmacokinetics of intravenously administered indomethacin in premature infants. J Pediatr97:995, 1980
11.
Brash AR, Hickey DE, Graham TP, et al: Pharmacokinetics of indomethacin in the neonate. New Engl J Med305:67, 1981
12.
Nadas AS: Indomethacin and the patent ductus arteriosus. New Engl J Med305:97, 1981
