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Abstract 382Poster Session III, Monday, 5/3 (poster 166)
Patency of the ductus arteriosus (PDA) in prematures leads to alterations in CBFV which, in turn have been associated with an increased risk of intraventricular hemorrhage (IVH). Previous studies of the effects of therapeutic indomethacin on CBFV have assessed only immediate, short term effects. We sought therefore to study longer term effects of indomethacin induced ductal closure on CBFV.Methods Preterm neonates ≤ 1750 gm. were evaluated during their first week of life for the presence of PDA. Decisions to treat PDA's were made by clinical staff not involved in the study, and treatment was initiated with a 36 hour course of indomethacin. In all study infants, cerebral pulsed doppler studies of the right middle cerebral artery were performed to assess systolic and diastolic flow velocity; velocity time intervals (VTI), reflective of cerebral blood flow; and pulsatility index (PI). In the treated infants, doppler studies were performed at time of diagnosis of PDA and at 24 and 48 hours following initiation of indomethacin therapy. In infants without PDA, studies were performed at approximately 5±2 days of age. Results PDA infants (n=28) and non-PDA infants (n=30) were similar in birth weight (1095±316 vs. 1223±403 gm) although the PDA infants were less mature (27.8±2.2 vs. 29.5±2.2 wk; p=0.005). All PDA's were closed at the time of the 48 hour studies. (Table)
