Prolonged Course Of Indomethacin For Treatment Of Patent Ductus Arteriosus In Preterm Infants And 6-ketoPGF₁α Levels Of Plasma

Objective:To determine the effectiveness and safety of prolonged versus short course of indomethacin for tretment of patent ductus arteriosus in preterm infants and 6-KetoPGF1αLevels of Plasma.Methods:56 infants of gestational ages 27 to 36 weeks were randomized to either short course dose(0.2mg/kg/dose in 36 hours) or prolonged low-dose indomethacin(0.15 mg/kg/dose in 48 hours).Echocardiography was done 24 to 72 hours after the last dose of the drug. 6-KetoPGF1αLevels of Plasma were tested before and after the treatment.The primary outcome measure was ductal closure rate,and other outcomes,and side effects.Results: Primary PDA closure occurred more in the prolonged course group (75% versus 64%,RR:1.17,95%CI intrval: 0.823~1.654).The incidence of transient oliguria was higher in the short course dose group,32% versus 7%,RR:0.22,95%CI interval:0.053~0.938. 6-KetoPGF1αLevels of Plasma had statistical difference before and after the treatment,but had no difference between the 2 dosing regiments.Conclusions:There was no difference in efficacy between the 2 dosing regimens. The Prolonged course indomethecin group had a lower rate of oliguria ,with the similar rate of NEC and the other bad short-term morbidities and outcome. The Prolonged course indomethecin may be as effective as the short course,with fewer side effects.In view of this,we recommmend using prolonged low-dose indomethacin for closing the patent arteriosus in the preterm infants whose birth weight more than 1.25kg. 6-KetoPGF1αLevels of Plasma fall down after the treatment.