Abstract 88

Background. Prophylactic bolus INDO is used to prevent IPVH, but produces an acute decrease in cerebral blood flow velocity (CBFV) that might be detrimental.

Aim. To compare incidence of adverse outcomes of two prophylactic INDO dosing methods on surfactant-treated VLBW infants with RDS.

Patients and Methods. With parental consent, 44 infants were stratified by weight (<1.0;1.0-1.5Kg), and randomised at <12 hrs to receive INDO (0.1 mg/Kg/24hrs × 6) by two dosing methods, in 5- (n=20) or 120-min (n=24) i.v. infusions. Exclusion criteria: congenital anomalies, prothrombin<50%, platelets<75,000/mm3, grade III-IV IPVH, and creatinine >1.8 mg/dL. A 5% statistical significance level was used.

Results. Mean birth weight (948±256 vs 956±295g), gestation (28±2 wks, in both groups), Apgar scores, prenatal steroids (65 vs 63%), and age at 1st dose were similar. Need for a 2nd INDO cycle, PDA-surgery or evidence of PDA at 28 days were also similar. 28-day-survival (60 vs 75%), DBP (25 vs 33%), total IVH (47 vs 38%), grade III-IV IVH (16 vs 8%), and PVL (0 vs 9%) were similar in both groups. Hydrocephaly was higher in the 5-min dosing group (21% vs 0; p<0.05).

Conclusion. Slow INDO dosing over 120-min is as effective as 5-min infusion, but might decrease adverse CNS-outcomes by producing a lesser decrease of CBFV.

(*)Arregui A (Leganés-Madrid), Closa R (Tarragona), Aguayo J, Canovas J (Sevilla), Fdez.-Lorenzo J (Santiago Compostela), Martínez-Santana S (Girona), Pantoja A (Toledo), Samaniego M (Granada).