Effect of indomethacin on closure of ductus arteriosus in very-low-birthweight neonates.
OBJECTIVE
To identify factors related to indomethacin non-responsiveness for patent ductus arteriosus (PDA) closure in very-low-birthweight (VLBW) neonates.


METHODS
A chart review of 107 VLBW neonates with a clinical diagnosis of PDA who received indomethacin, admitted to a tertiary neonatal intensive care unit in Toronto, Canada, was conducted (study period November 2001 to October 2003). Positive responders were those with no clinical evidence of PDA for 72 h after indomethacin.


RESULTS
Response to the first course of indomethacin was 75%, and to the second course 67% among initial responders. Higher CRIB score (OR 1.15, 95% CI 1.02-1.31) and early surfactant administration (OR 3.74, 95% CI 1.04-13.47) were associated with non-responsiveness to indomethacin.


CONCLUSIONS
Indomethacin is effective for PDA closure. The response rate diminished with subsequent courses. Early surfactant and severity of illness at admission were associated with non-responsiveness to indomethacin.
Godambe
Sunit
S
Department of Paediatrics, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
Newby
Brandi
B
Shah
Vibhuti
V
Shah
Prakesh S
PS
D002317:Cardiovascular Agents / Q000627:therapeutic use*; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D019102:Infant, Very Low Birth Weight; D008297:Male; D011663:Pulmonary Surfactants / Q000627:therapeutic use
D002317:Cardiovascular Agents; D011663:Pulmonary Surfactants; D007213:Indomethacin