| Comparison of Continuous Versus Intermittent Infusion of Indomethacin in PDA of Preterm Infants |
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Yun Kyoung Lee, Hee Seok Kim, Kyoung Ran Park, Chan Hu Park, June Dong Park, Beyong Il Kim, Woong Heum Kim, Jung Hwan Choi, Chong Ku Yun |
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Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea |
| 미숙아 동맥관 개존증의 치료에서 인도메타신의 간헐적 정주와 연속 정주의 치료효과 및 부작용의 비교 |
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이윤경, 김희석, 박경란, 박찬후, 박준동, 김병일, 김웅흠, 최중환, 윤종구 |
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서울대학교 의과대학 소아과학교실 |
Correspondence:
Jung Hwan Choi, Email: 1
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| Abstract |
Purpose
: Patent ductus arteriosus(PDA) of prematurity is very important disease to study because
it causes many cases of perinatal morbidity and its incidence is now increasing. Nowadays
indomethacin is the drug of choice for PDA closure, but its use has been limited due to its side
effects. Therefore, we compared the effect and side effects of indomethacin according to the infusion
method
, continuous versus intermittent infusion, to find better an administration method.
Methods
: Twenty-five preterm infants who were admitted to Seoul National University Children' s
Hospital(SNUCH) NICU from March 1995 to August 1996 with a diagnosis of respiratory distress
syndrome(RDS) and PDA, were enrolled. They were randomly assigned to intertmittent Ⅳ group or
continuous Ⅳ group. Each group received three intermittent doses or continuous infusion over 36
hours, respectively. We analyzed the perinatal history, time of diagnosis and treatment of PDA, size
of PDA, and compared the laboratory parameters, intraventricular hemorrhage(IVH), periventricular
echogenecity(PVE), ductal closure and perinatal morbidity before and 48 hours after indomethacin
administration between the two groups.
Results
: Fourteen infants(birth weight 1,149±373g) were intermittent Ⅳ group and eleven infants
(birth weight 1,212±504g) were continuous Ⅳ group. There were no significant difference between
the groups in perinatal history, pretreatment laboratory parameters, ductal closure, and perinatal
morbidity. Patients with IVH of grade 2 or more increased significantly in intermittent Ⅳ group
(50%) compared to continuous Ⅳ group(9%), and PVE progressed significantly in intermittent Ⅳ
group(64%) compared to continuous Ⅳ group(18%).
Conclusion
: Continuous infusion of indomethacin for PDA closure in preterm infants with RDS
appears to be as effective as intermittent infusion of indomethacin in closing PDA and have less
side effects such as IVH and PVE progress. |
| Key Words:
Indomethacin, Preterm infants, Patent ductus arteriosus |
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