Introduction Treatment of preterm infants with INDO to close patent ductus arteriosus (PDA) reduces cerebral blood flow (CBF) and brain oxygen delivery. Recently IBU, a PG-synthesis inhibitor which does not alter CBF in piglets, was proved to close PDA in human newborns. We have compared the effects on cerebral perfusion and oxygenation of INDO and IBU in preterm infants with echocardiographic diagnosis of hemodynamically significant PDA.
Method Eight infants of mean gestational age (GA) 28 ± 2 weeks (25-30), mean birth weight (BW) 908 ± 295 g (600-1390), age 45± 52 hours (5-120) were studied during the the first dose (0.2 mg/kg) of INDO; 8 infants of GA 29 ± 3 w (27-31), BW 1005 ± 308 g(620-1620), age 23 ± 15 h (10-53) during the first dose (10 mg/kg) of IBU. Near infrared spectroscopy (NIRS) (NIRO 500, Hamamatsu Photonics), a technique based on the differential absorbtion of NIR light (700-900 nm) by hemoglobin and cytochrome a,a3 depending on their oxidation state, was employed to assess relative changes in cerebral blood volume (CBV), calculated from changes in total hemoglobin (ΔHbtot), absolute variations of CBV, modifications of cerebral oxygen availability, indicated by the difference:[oxyhemoglobin] - [deoxyhemoglobin] (ΔHbdiff) and changes in oxidized cytochrome a,a3 (ΔCytO2). Moreover, CBF velocity (CBFV) was assessed using Doppler ultrasonography.
