Failure of indomethacin to close persistent ductus arteriosus in infants weighing under 1000 grams.
Six preterm infants with a persistent ductus arteriosus, who failed to improve with conventional medical management, received indomethacin in an attempt to close the duct pharmacologically. All infants weighed less than 1000 g when the drug was administered. All showed a transient response to indomethacin; however, no infant demonstrated a permanent response, even though 5 of the 6 received multiple doses. One of the patients developed a severe episode of anuria, uraemia, and gastrointestinal bleeding. Of the 6 infants, 3 underwent subsequent successful surgical ligation of the ductus. It is suggested that the extremely preterm infant may be a 'poor responder' to indomethacin. Since the side effects of indomethacin may be life-threatening, it may be wise to consider surgical ligation in lieu of indomethacin administration in these infants.
D001002:Anuria / Q000139:chemically induced; D004071:Digitalis Glycosides / Q000627:therapeutic use; D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007213:Indomethacin / Q000009:adverse effects / Q000627:therapeutic use*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D014511:Uremia / Q000139:chemically induced
D004071:Digitalis Glycosides; D007213:Indomethacin