Abstract
To determine whether altered production of vasoactivc eicosanoids precedes the development of symptomatic patent ductus arteriosus (SPDA) in infants who have received prophylactic indomethacin (I), major urinary metabolites of thromboxane, prostacyclin and PGE2 were measured by gas chromatography-mass spectrometry. The 4 infants (26-27 wks gestation; 840-870 gm birth weight), 2 of whom had SPDA on days 6 and 11 were matched for birth weight, gestational age, race, severity of hyaline membrane disease and intensity of ventilatory support. All received prophylactic I, 0.2 mg/kg 24 hr after birth. Serum I was 582-1283 mg/ml and 155-960 ng/ml 24 and 96 hrs post dose respectively. There were no differences in urinary PG excretion patterns between infants who were protected and infants who developed SPDA, except that the symptomatic infants showed marked suppression of PG excretion when given additional I as treatment. Failure of I to protect against SPDA appears unrelated to systemic production of vasoactive PGs. Scrum levels of I did not discriminate babies likely to develop SPDA despite prophylactic treatment. There appears to be no rationale for increasing the prophylactic dose of I to afford greater protection from SPDA. The role of PGs in the onset of SPDA following prophylactic I remains to be elucidated.
This work was supported by SCOR HL-14214 and HD-17413.
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Haywood, J., Fitzgerald, G. & Cotton, R. SYSTEMIC PRODUCTION OF VASODILATOR EICOSANOIDS IS NOT INCREASED IN INFANTS WITH SYMPTOMATIC PATENT DUCTUS ARTERIOSUS (SPDA) WHO FAIL INDOMETHACIN PROPHYLAXIS. Pediatr Res 21 (Suppl 4), 236 (1987). https://doi.org/10.1203/00006450-198704010-00413
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DOI: https://doi.org/10.1203/00006450-198704010-00413