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Abstract
Purpose :
Indomethacin has been reported as the prophylaxis and initial treatment of preterm infants with patent ductus arteriosus (PDA). However, there was controversy over indomethacin treatment in full-term infants with symptomatic PDA. Therefore, we evaluate the effect of indomethacin as a treatment of full-term infants with symptomatic PDA.
Methods :
A retrospective study was performed to evaluate the effectiveness of indomethacin in full-term infants who had birth weight ≥2,500 g and a gestational age ≥37 weeks with symptomatic PDA at Chonnam National University Hospital between January 2007 and December 2009. According to responsiveness of indomethacin, we classified them into three groups: 1) complete responder which were completely closed after indomethacin treatment, 2) partial responder which were incompletely closed but symptoms were improved, 3) non responder which were conducted surgical ligation because did not respond.
Results :
Among the total 29 full-term infants treated with indomethacin, 13 (44.8%) were complete responder, 8 (27.6%) were partial responder, and 8 (27.6%) were non responder. There were no significant differences in birth weight, narrow diameter of PDA, and dose of indomethacin between three groups. However, the age at initiation of treatment using indomethacin of complete (4.8±4.5 days, P=0.03) and partial responder (6.3±2.0 days,P=0.04) were earlier than those of non responder (13.8±8.1 days).
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Table 1.
Clinical Characteristics of Complete, Partial, and Non-responder Groups Treated with Indomethacin in Full-term Infants with Symptomatic Patent Ductus Arteriosus
| Complete responder group (n=13) | Partial responder group (n=8) | Non responder group (n=8) | |
|---|---|---|---|
| Male/Female | 8/5 | 4/4 | 2/6 |
| Gestational age (weeks) | 39.4±1.3 | 38.9±1.3 | 38.3±0.5∗ |
| Birth weigh† (g) | 3,135±393 | 3,111±346 | 3,314±451 |
| Chromosome abnormality | 1 (Edwards syndrome) | 1 (Down syndrome) | 1 (Down syndrome) |
| Intra ventricular hemorrhage, grade I, n (%) | 3 (23.1) | 0 (0) | 0 (0.0) |
| Ventilatory support, n (%) | 3 (23.1) | 2 (25.0) | 1 (12.5) |
| Oxygen supply, n (%) | 6 (46.2) | 2 (25.0) | 4 (50.0) |
| Age at initiation of treatment (days) | 4.8±4.5 | 6.3±2.0 | 13.8±8.1∗† |
| Narrow diameter of the DA (mm) | 3.5±1.4 | 3.1±1.2 | 3.8±1.3 |
| Total dose of indomethacin | 3.8± 2.0 | 5.3±1.4 | 4.1±1.6 |
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