Short versus prolonged indomethacin therapy for patent ductus arteriosus in preterm infants
Objective: To evaluate whether a prolonged low-dose course of indomethacin would produce an improved closure rate and have fewer side effects compared with a short standard dosage schedule in the management of patent ductus arteriosus (PDA) in preterm infants. Study design: Sixty-one infants of gest...
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| Veröffentlicht in: | The Journal of pediatrics 1999-05, Vol.134 (5), p.552-557 |
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| container_title | The Journal of pediatrics |
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| creator | Tammela, Outi Ojala, Riitta Iivainen, Tiina Lautamatti, Visa Pokela, Marja-Leena Janas, Martti Koivisto, Maila Ikonen, Sami |
| description | Objective: To evaluate whether a prolonged low-dose course of indomethacin would produce an improved closure rate and have fewer side effects compared with a short standard dosage schedule in the management of patent ductus arteriosus (PDA) in preterm infants.
Study design: Sixty-one infants of gestational ages 24 to 32 weeks with a PDA confirmed with echocardiography were randomized to receive 0.2 to 0.1 to 0.1 mg/kg indomethacin in 24 hours (short course, n = 31) or 0.1 mg/kg every 24 hours 7 times (long course, n = 30). Echocardiography was done 3, 9, and 14 days after the treatment was started, and side effects were monitored.
Results: Primary PDA closure occurred more often in the short course group (94% vs 67%,
P = .011), but the sustained closure rates were not different (74% vs 60%). Surgical PDA ligations were less frequent in the short course group than in the long course group. The short course group had a shorter duration of oxygen supplementation, less frequent symptoms of necrotizing enterocolitis, and a lower rate of urea retention. Mortality and other neonatal morbidity rates were similar.
Conclusion: A prolonged low-dosage indomethacin regimen offers no advantage compared with a standard-dosage short course in the management of a hemodynamically significant PDA in preterm infants. (J Pediatr 1999;134:552-7) |
| doi_str_mv | 10.1016/S0022-3476(99)70239-8 |
| format | Article |
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Study design: Sixty-one infants of gestational ages 24 to 32 weeks with a PDA confirmed with echocardiography were randomized to receive 0.2 to 0.1 to 0.1 mg/kg indomethacin in 24 hours (short course, n = 31) or 0.1 mg/kg every 24 hours 7 times (long course, n = 30). Echocardiography was done 3, 9, and 14 days after the treatment was started, and side effects were monitored.
Results: Primary PDA closure occurred more often in the short course group (94% vs 67%,
P = .011), but the sustained closure rates were not different (74% vs 60%). Surgical PDA ligations were less frequent in the short course group than in the long course group. The short course group had a shorter duration of oxygen supplementation, less frequent symptoms of necrotizing enterocolitis, and a lower rate of urea retention. Mortality and other neonatal morbidity rates were similar.
Conclusion: A prolonged low-dosage indomethacin regimen offers no advantage compared with a standard-dosage short course in the management of a hemodynamically significant PDA in preterm infants. (J Pediatr 1999;134:552-7)</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/S0022-3476(99)70239-8</identifier><identifier>PMID: 10228288</identifier><identifier>CODEN: JOPDAB</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cyclooxygenase Inhibitors - administration & dosage ; Cyclooxygenase Inhibitors - therapeutic use ; Ductus Arteriosus, Patent - diagnosis ; Ductus Arteriosus, Patent - drug therapy ; Echocardiography ; Emergency and intensive care: neonates and children. Prematurity. Sudden death ; Gestational Age ; Humans ; Indomethacin - administration & dosage ; Indomethacin - therapeutic use ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases - drug therapy ; Intensive care medicine ; Medical sciences ; Treatment Outcome</subject><ispartof>The Journal of pediatrics, 1999-05, Vol.134 (5), p.552-557</ispartof><rights>1999 Mosby, Inc.</rights><rights>1999 INIST-CNRS</rights><rights>Copyright Mosby-Year Book, Inc. May 1999</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c417t-cea532474664a421f1b4af853f51c770894de3f250d5788adfd5c99e4b9442da3</citedby><cites>FETCH-LOGICAL-c417t-cea532474664a421f1b4af853f51c770894de3f250d5788adfd5c99e4b9442da3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0022-3476(99)70239-8$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1803840$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10228288$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tammela, Outi</creatorcontrib><creatorcontrib>Ojala, Riitta</creatorcontrib><creatorcontrib>Iivainen, Tiina</creatorcontrib><creatorcontrib>Lautamatti, Visa</creatorcontrib><creatorcontrib>Pokela, Marja-Leena</creatorcontrib><creatorcontrib>Janas, Martti</creatorcontrib><creatorcontrib>Koivisto, Maila</creatorcontrib><creatorcontrib>Ikonen, Sami</creatorcontrib><title>Short versus prolonged indomethacin therapy for patent ductus arteriosus in preterm infants</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>Objective: To evaluate whether a prolonged low-dose course of indomethacin would produce an improved closure rate and have fewer side effects compared with a short standard dosage schedule in the management of patent ductus arteriosus (PDA) in preterm infants.
Study design: Sixty-one infants of gestational ages 24 to 32 weeks with a PDA confirmed with echocardiography were randomized to receive 0.2 to 0.1 to 0.1 mg/kg indomethacin in 24 hours (short course, n = 31) or 0.1 mg/kg every 24 hours 7 times (long course, n = 30). Echocardiography was done 3, 9, and 14 days after the treatment was started, and side effects were monitored.
Results: Primary PDA closure occurred more often in the short course group (94% vs 67%,
P = .011), but the sustained closure rates were not different (74% vs 60%). Surgical PDA ligations were less frequent in the short course group than in the long course group. The short course group had a shorter duration of oxygen supplementation, less frequent symptoms of necrotizing enterocolitis, and a lower rate of urea retention. Mortality and other neonatal morbidity rates were similar.
Conclusion: A prolonged low-dosage indomethacin regimen offers no advantage compared with a standard-dosage short course in the management of a hemodynamically significant PDA in preterm infants. (J Pediatr 1999;134:552-7)</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cyclooxygenase Inhibitors - administration & dosage</subject><subject>Cyclooxygenase Inhibitors - therapeutic use</subject><subject>Ductus Arteriosus, Patent - diagnosis</subject><subject>Ductus Arteriosus, Patent - drug therapy</subject><subject>Echocardiography</subject><subject>Emergency and intensive care: neonates and children. Prematurity. Sudden death</subject><subject>Gestational Age</subject><subject>Humans</subject><subject>Indomethacin - administration & dosage</subject><subject>Indomethacin - therapeutic use</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infant, Premature, Diseases - drug therapy</subject><subject>Intensive care medicine</subject><subject>Medical sciences</subject><subject>Treatment Outcome</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkM2KFDEUhYMoTtv6CEohIroozV9VktUgg38w4GJ05SKkkxs7Q1VSJqmBeXvT042KG1c3l3zncvgQekrwG4LJ-PYKY0p7xsX4SqnXAlOmenkPbQhWoh8lY_fR5jdyhh6Vco0xVhzjh-iMtA9Jpdyg71f7lGt3A7mspVtymlL8Aa4L0aUZ6t7YELu6h2yW286n3C2mQqydW21tAZMr5JAO2cYtGdo6t6c3sZbH6IE3U4Enp7lF3z68_3rxqb_88vHzxbvL3nIiam_BDIxywceRG06JJztuvByYH4gVAkvFHTBPB-wGIaVx3g1WKeA7xTl1hm3Ry-PdVv_nCqXqORQL02QipLXoUQnGOB4a-Pwf8DqtObZumqhWgB7ALRqOkM2plAxeLznMJt9qgvVBvb5Trw9etVL6Tr2WLffsdHzdzeD-Sh1dN-DFCTDFmslnE20ofziJmeS4YedHDJqymwBZFxsgWnAhg63apfCfJr8ArSqgxQ</recordid><startdate>19990501</startdate><enddate>19990501</enddate><creator>Tammela, Outi</creator><creator>Ojala, Riitta</creator><creator>Iivainen, Tiina</creator><creator>Lautamatti, Visa</creator><creator>Pokela, Marja-Leena</creator><creator>Janas, Martti</creator><creator>Koivisto, Maila</creator><creator>Ikonen, Sami</creator><general>Mosby, Inc</general><general>Elsevier</general><general>Mosby-Year Book, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>19990501</creationdate><title>Short versus prolonged indomethacin therapy for patent ductus arteriosus in preterm infants</title><author>Tammela, Outi ; Ojala, Riitta ; Iivainen, Tiina ; Lautamatti, Visa ; Pokela, Marja-Leena ; Janas, Martti ; Koivisto, Maila ; Ikonen, Sami</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c417t-cea532474664a421f1b4af853f51c770894de3f250d5788adfd5c99e4b9442da3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cyclooxygenase Inhibitors - administration & dosage</topic><topic>Cyclooxygenase Inhibitors - therapeutic use</topic><topic>Ductus Arteriosus, Patent - diagnosis</topic><topic>Ductus Arteriosus, Patent - drug therapy</topic><topic>Echocardiography</topic><topic>Emergency and intensive care: neonates and children. Prematurity. Sudden death</topic><topic>Gestational Age</topic><topic>Humans</topic><topic>Indomethacin - administration & dosage</topic><topic>Indomethacin - therapeutic use</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infant, Premature, Diseases - drug therapy</topic><topic>Intensive care medicine</topic><topic>Medical sciences</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tammela, Outi</creatorcontrib><creatorcontrib>Ojala, Riitta</creatorcontrib><creatorcontrib>Iivainen, Tiina</creatorcontrib><creatorcontrib>Lautamatti, Visa</creatorcontrib><creatorcontrib>Pokela, Marja-Leena</creatorcontrib><creatorcontrib>Janas, Martti</creatorcontrib><creatorcontrib>Koivisto, Maila</creatorcontrib><creatorcontrib>Ikonen, Sami</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tammela, Outi</au><au>Ojala, Riitta</au><au>Iivainen, Tiina</au><au>Lautamatti, Visa</au><au>Pokela, Marja-Leena</au><au>Janas, Martti</au><au>Koivisto, Maila</au><au>Ikonen, Sami</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Short versus prolonged indomethacin therapy for patent ductus arteriosus in preterm infants</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>1999-05-01</date><risdate>1999</risdate><volume>134</volume><issue>5</issue><spage>552</spage><epage>557</epage><pages>552-557</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><coden>JOPDAB</coden><abstract>Objective: To evaluate whether a prolonged low-dose course of indomethacin would produce an improved closure rate and have fewer side effects compared with a short standard dosage schedule in the management of patent ductus arteriosus (PDA) in preterm infants.
Study design: Sixty-one infants of gestational ages 24 to 32 weeks with a PDA confirmed with echocardiography were randomized to receive 0.2 to 0.1 to 0.1 mg/kg indomethacin in 24 hours (short course, n = 31) or 0.1 mg/kg every 24 hours 7 times (long course, n = 30). Echocardiography was done 3, 9, and 14 days after the treatment was started, and side effects were monitored.
Results: Primary PDA closure occurred more often in the short course group (94% vs 67%,
P = .011), but the sustained closure rates were not different (74% vs 60%). Surgical PDA ligations were less frequent in the short course group than in the long course group. The short course group had a shorter duration of oxygen supplementation, less frequent symptoms of necrotizing enterocolitis, and a lower rate of urea retention. Mortality and other neonatal morbidity rates were similar.
Conclusion: A prolonged low-dosage indomethacin regimen offers no advantage compared with a standard-dosage short course in the management of a hemodynamically significant PDA in preterm infants. (J Pediatr 1999;134:552-7)</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>10228288</pmid><doi>10.1016/S0022-3476(99)70239-8</doi><tpages>6</tpages></addata></record> |
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| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cyclooxygenase Inhibitors - administration & dosage Cyclooxygenase Inhibitors - therapeutic use Ductus Arteriosus, Patent - diagnosis Ductus Arteriosus, Patent - drug therapy Echocardiography Emergency and intensive care: neonates and children. Prematurity. Sudden death Gestational Age Humans Indomethacin - administration & dosage Indomethacin - therapeutic use Infant, Newborn Infant, Premature Infant, Premature, Diseases - drug therapy Intensive care medicine Medical sciences Treatment Outcome |
| title | Short versus prolonged indomethacin therapy for patent ductus arteriosus in preterm infants |
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