EFFECTS OF INTRAVENOUS INDOMETHACIN ON PLASMA 6KPGF_1α and TxB₂ CONCENTRATIONS IN NEONATES WITH PATENT DUCTUS ARTERLOSUS AND PULMONARY DISEASE

Abstract

The immediate effect of 0.2mg/kg indanethacin on the plasma concentration of 6-keto-prostaglandin F_1α. (6-KF_1α) and thromboxane (TxB₂) was studied in 10 preterm babies with sympatomatic patent ductus arteriosus (PDA) in the first week of life.

Gestational age ranged from 25-31 weeks and birthweight 660-1295g. The concentration of 6-KF_1α before indomethacin, range 255-3487pg/ml was much higher than previously reported in well preterm babies. This decreased after indomethacin in 6 babies. In 3 there was a small initial increase but 6 hours later the concentration was lower than pre-indanethacin. TxB₂, also higher than in well preterm babies, range 247-4991pg/ml, increased in all who continued to need assisted ventilation (5) but decreased in all those who could be extubated within 72 hours of treatment (5). These results suggest that co-existing lung disease in babies with PDA is associated with a paradoxical effect of indomethacin. This may be responsible for the phenomenon of "transient closure" which, in a clinical study of 30 babies was significantly related to the presence or absence of pulmonary disease (p<0.005). Indanethacin is unlikely to lead to permanent closure of PDA when there is co-existing pulmonary disease which may alter prostaglandin metabolism.

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