Abstract
Using near infrared spectroscopy (NIRS) we have shown previously that the intravenous administration of indomethacin for treatment of patent ductus arteriosus (PDA) in sick preterm infants caused a reduction of approximately 40% in cerebral oxygen delivery1. We have used NIRS to investigate the effect of this change on the cerebral concentration of oxidised cytochrome aa3 ((CytO2]), the terminal enzyme in the mitochondrial electron transport chain.
Studies by NIRS were performed on 15 infants born at 23-29 weeks gestation weighing 600-1620 grams, who required treatment for PDA aged 8-27 days. Infants received indomethacin 0.1-0.2 mg.kg−, seven by fast (30 sees) and eight by slow (30 mins) infusion. The expected haemodynamic changes were seen in all infants. In 5 infants an unequivocal fall in [CytO2] was observed (range 0.3-0.9 μmol.1−), while the remaining 10 infants showed no definite change. No significant difference between the fast and slow infusion was observed.
We conclude that following indomethacin the close relationship between cerebral intracellular oxygen supply and cerebral energy metabolism was frequently maintained, but in 5 cases there was evidence of a relative intracellular oxygen deficit.
1. AD Edwards et al. Pediatr Res 1989:26:522
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McCormick, D., Edwards, A., Wyatt, J. et al. 80 Effect of indomethacin on cerebral oxidised cytochrome aa3 concentration in preterm infants. Pediatr Res 28, 290 (1990). https://doi.org/10.1203/00006450-199009000-00104
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DOI: https://doi.org/10.1203/00006450-199009000-00104