Indomethacin Impairs Coronary Perfusion in Infants with Hemodynamically Significant Ductus Arteriosus
Sehgal A et al. – Intravenous indomethacin was followed by a decline in coronary arterial diastolic blood flow.Methods
- A prospective observational echocardiographic study was performed on preterm infants.
- A single study dose of intravenous indomethacin (0.1 mg/kg) was administered over 1 h.
- Serial echocardiography was performed before and after indomethacin treatment to study the effect on coronary artery perfusion and cardiovascular performance.
- Eighteen infants born at a median gestation of 25.8 (24.2, 28.1) weeks and a birth weight of 773 g (704, 1,002) were evaluated.
- The median age at indomethacin administration was 7.5 days (4, 17).
- There was no significant change in arterial pressure or ventilatory indices.
- Left anterior descending artery diastolic velocity and time integral declined from 0.3 ± 0.1 and 3.19 ± 1.2 m/s to 0.22 ± 0.08 and 2.01 ± 0.9 m/s, respectively, within 10 min of completion of infusion.
- These indices showed partial recovery when reassessed after 60 min.
- There were no changes in left ventricular output or transductal flow.