AI Article Synopsis
- A significant patent ductus arteriosus (PDA) in preterm newborns can lead to higher health risks, prompting the use of indomethacin for treatment.
- The study monitored 18 preterm infants, measuring their cerebral oxygen levels before and after administering indomethacin to assess its effects.
- Results showed a notable increase in cerebral oxygen extraction shortly after indomethacin treatment, indicating a potential protective mechanism, suggesting further research is needed.
Article Abstract
Background: A significant patent ductus arteriosus (PDA) is a common finding in the first days of life and, if persistent, is associated with an increased morbidity and mortality in the preterm newborn.
Objectives: Our aim was to investigate, using near-infrared spectroscopy, the effect of indomethacin on the fractional tissue (cerebral) oxygen extraction (FT(c)OE) in a group of preterm newborns undergoing medical treatment for a PDA.
Methods: This is a prospective, observational study. A cohort of 18 preterm newborns (<32 weeks) undergoing treatment for a PDA with indomethacin were monitored continuously for mean arterial blood pressure, arterial oxygen saturation (SpO(2)) and regional cerebral oxygen saturation (r(c)SO(2)). Measurements were started 1 h before and continued for 4 h after the first indomethacin dose. A final measurement (1 h) was made within 24 h of completing the full course. FT(c)OE = [SpO(2) - r(c)SO(2)]/SpO(2) was then calculated. To analyze the data, we chose to average the measurements over 1-hour periods.
Results: There was a significant increase in the FT(c)OE (0.06, 95% CI 0.04-0.09, p < 0.001) noticeable within the 1st hour after the start of indomethacin administration, which peaked in the 2nd hour (FT(c)OE increased by 0.08, 95% CI 0.04-0.11, p < 0.001) and lasted for the full 4-hour period measured.
Conclusion: Indomethacin, infused over 30 min, significantly increased the FT(c)OE in the preterm newborn, the effect lasting at least 4 h. This may represent a protective response to the indomethacin-induced reduction in cerebral blood flow demonstrated by others and warrants further investigation.
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| http://dx.doi.org/10.1159/000283946 | DOI Listing |
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