Effects on cerebral blood flow velocities of slow and rapid infusion of indomethacin.
In a randomized study, indomethacin was administered either by an intravenous rapid infusion or by a 30-minute intravenous infusion to preterm infants. Ten infants were randomly assigned to the rapid infusion group and nine to the other group. Time-averaged mean systolic, mean flow velocity, and mean diastolic blood flow velocities were measured in the internal carotid artery with a pulsed Doppler. Blood flow velocities, arterial blood gases, intraarterial blood pressures, and transcutaneous PO2 and PCO2 were measured at 5 and 1 minutes before indomethacin and then at 5, 10, 20, 30, 35, 40, 50, 60, and 90 minutes after indomethacin administration. Intravenous indomethacin either by rapid or slow infusion caused a significant decrease in the blood flow velocities. The blood flow velocities were significantly lower 5 minutes after rapid infusion and by 30 minutes in the slow-infusion group. In both groups, the blood flow velocities remained depressed up to 90 minutes. The blood pressures increased concomitantly to the blood flow velocities in the rapid-administration group only. Because indomethacin given for 30 minutes does not avoid the decrease in the blood flow velocities, further studies are necessary to ascertain the safest method of administration.
Simko
A
A
Department of Pediatrics, University of California, San Diego 92103.
Mardoum
R
R
Merritt
T A
TA
Bejar
R
R
D001783:Blood Flow Velocity / Q000187:drug effects; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D004311:Double-Blind Method; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007213:Indomethacin / Q000008:administration & dosage*; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D011446:Prospective Studies; D014463:Ultrasonography
D007213:Indomethacin