Abstract
Because indomethacin interferes with normal platelet aggregation, its use has been contraindicated in infants with an intra-cranial hemorrhage (ICH). From 1/81 to 8/83 we examined 1) all infants less than 1250g and 2) infants between 1250-1500g who had respiratory distress for the presence of an ICH by ultrasonography within the first 4 days after birth. There were 33 infants who had an ICH diagnosed within the first 4 days (mean age 2.6 ± 1.0 days, ± SD). They were reexamined by ultrasound at 3-7 day intervals for extension of their ICH. An ICH was considered to have extended if the ICH had either: 1) increased in size within the germinal matrix, 2) appeared in a new parenchymal site, or 3) extended into the ventricle. 16 infants had a PDA and were treated with indomethacin (0.4 mg/kg over 36 hr) after the initial ICH was diagnosed. The age for starting indomethacin was 4.1 ± 0.9 days. 17 infants did not have a PDA and did not receive indomethacin. Both the indomethacin-treated and non-treated groups were similar in birthweight, gestational age, gender, Apgar scores, incidence of IRDS, timing of the initial ultrasound scan, number of followup scans (5.4 ± 2.6), as well as the location (germinal matrix alone = 13, GM or parenchymal plus IVH = 20) and the degree of hemorrhage in the initial scans. Only one of 16 (6.3%) who received indomethacin versus 2 of 17 (11%) who did not receive it, had extension of their initial ICH. Although indomethacin may alter platelet function it does not appear to cause extension of a preexisting ICH.
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Maher, P., Lane, B., Ballard, R. et al. CAN INDOMETHACIN BE USED IN INFANTS WITH AN INTRACRANIAL HEMORRHAGE?. Pediatr Res 18 (Suppl 4), 1330 (1984). https://doi.org/10.1203/00006450-198404001-01334
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DOI: https://doi.org/10.1203/00006450-198404001-01334