Abstract
Introduction: We decided to investigate the effects of injecting Indomethacin on reducing complications of Patent Ductus Arteriosus (PDA) and the need for prolonged mechanical ventilation. Methods: During this randomized clinical trial, 70 premature infants with matched gestational age and birth weight were divided into case and control groups. In the study group, intravenous indomethacin started from the first 2-12 hours of birth. All patients were followed by echocardiography at the fourth day and skull ultrasound in the second week. Results: Symptomatic PDA rate was significantly higher in the control group (25.7% vs. 0%; P≤0.001). Incidence of grade 1-3 intraventricular hemorrhage was higher in the control group and the ratio of needed time for respiratory support in the control group to the case group was approximately 2.1. Conclusion: Intravenous Indomethacin reduced the number of PDA cases and incidence of grade 2 and 3 intraventricular hemorrhage, without any short term side effects.
Highlights
We decided to investigate the effects of injecting Indomethacin on reducing complications of Patent Ductus Arteriosus (PDA) and the need for prolonged mechanical ventilation
Spontaneous closure of Patent Ductus Arteriosus (PDA) could happen in the first year, but since it increases the risk of endocarditis, its closure is suggested to happen in 6-month age, but drug-induced or surgical closure is needed for infants who are very birth low weight.[2,3,4]
Eight infants (22.8%) from study group were under ventilator for 1.46±0.66 days, but in control group 10 infants (28.5%) underwent ventilation for 4.16±2.93 days
Summary
We decided to investigate the effects of injecting Indomethacin on reducing complications of Patent Ductus Arteriosus (PDA) and the need for prolonged mechanical ventilation. Its shrinkage and closure starts from pulmonary artery side and continues to aorta in a cone shape.[1,2] Spontaneous closure of Patent Ductus Arteriosus (PDA) could happen in the first year, but since it increases the risk of endocarditis, its closure is suggested to happen in 6-month age, but drug-induced or surgical closure is needed for infants who are very birth low weight (under 1000 g).[2,3,4] PDA therapy consists of restricting fluid intake, administering prostaglandin inhibitors (such as indomethacin) and surgical closure.[4] After birth, indomethacin causes shrinkage, ischemia and rearrangement in the structure of the arterial duct, duct closure and reduces the need for surgical intervention.[3,5] So this motivated clinical researchers to use this drug after birth upon suspected initial symptoms.[5,6]
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