| Autor: |
Marvin, William J, Roskoski, Robert, Hermsmeyer, R Kent, Lauer, R M |
| Zdroj: |
Pediatric Research; April 1977, Vol. 11 Issue: 4 p395-395, 1p |
| Abstrakt: |
Indomethacin (IND) has recently been shown effective in closing the patent ductus arteriosus (PDA) in small premature infants. However, this mode of therapy has not been evaluated in older infants or children. We have given IND to 6 patients (pts.) with isolated PDA's ranging in age from 51 days to 6 years. All pts. had typical auscultatory findings of a PDA, widened pulse pressure and 5 pts. had electrographic evidence of left ventricular hypertrophy. Four pts. demonstrated cardiomegaly and increased pulmonary blood flow on chest x-ray. Three pts. had the diagnosis of PDA confirmed by cardiac catheterization to exclude associated cardiac anomalies. Echocardiography in 5 pts. revealed LA/AO ratios ranging from 1.2 to 2.0. IND was given orally in a dose ranging from 0.2 mg/kg to 1 mg/kg (1 pt.). Four pts. received 0.3 mg/kg for 2 doses 24 hours apart. In all 6 pts., the clinical & laboratory findings of a PDA remained after the course of IND was completed. Documentation of the patency of the PDA was demonstrated at surgery in 3 pts.; 3 additional pts. are awaiting surgical ligation. Our data suggest that there is an age-related mechanism for prostaglandin inhibition which was probably absent after 50 days of age in our pts. At the present time there seems to be no role for IND in the medical therapy of PDA's in older infants and children. |
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