Abstract 1049 Poster Session I, Saturday, 5/1 (poster 59)

Indomethacin is used frequently for pharmacologic closure of a symptomatic patent ductus arteriosus in preterm infants. Renal dysfunction and increased incidence of necrotizing enterocolitis have been reported in infants who were treated with indomethacin. Decreased renal, mesenteric and cerebral blood flow measured by Doppler ultrasound study after indomethacin treatment have been reported in neonates and laboratory animals. We reported that dopamine induces an increase in renal blood flow velocity in preterm neonates (J Pediatr 133:728, 1998). To evaluate a possible protective effect of dopamine on vasoconstrictive action of indomethacin we studied the vascular response to dopamine in renal (RA), superior mesenteric (SMA), middle cerebral (MCA) and femoral (FA) arteries and descending aorta (DAo) in 9 non-hypotensive neonates (BW 966±399SD, range 553 to 1610gms; GA 27.3± .77SD, range 25 to 32 wks postnatal age 1.9 ± .8 SD, range 1- 3 days). All infants had one dose of indomethacin 6-8 hours prior to the study. Blood flow profile was measured by an Acuson XP color and duplex Doppler unit with a 5.0/7.0 MHertz sector probe at a close to zero angle of insertion. Peak systolic, end diastolic and time averaged mean velocity were obtained, and the pulsatility index was calculated before and 10 minutes after the initiation of 5ug/kg/min dopamine infusion. The mean ± SD value for pulsatility index (PI) and mean arterial blood pressure (BP) are shown in the table. We conclude that low dose dopamine attenuates the renal, but not the mesenteric or cerebral vasoconstrictive effects of indomethacin in normotensive preterm neonates.

Table 1 No caption available
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