Abstract 176

Ninety three infants (<1500 gm) who had symptomatic PDA (Echo proved L→R shunt and signs of cardiovascular dysfunction) and required mechanical ventilation were randomly assigned to two therapeutic regimen: 1) Gr I. (46 infants) received Ind. 0.2 mg/kg iv as initial dose, then 0.1 mg/kg in infants < 48 hrs or 0.2 mg/kg in infants ≥ 48 hrs, q.12.hr for another 2 doses; 2) Gr II. (47 infants) received Ind. 0.2 mg/kg iv as initial dose, the subsequent dose was given only if the pulsatile or growing PDA flow pattern persisted. The growing pattern was defined as a bi-directional flow but with a predominant L→R shunt; the pulsatile pattern was defined as a L→R shunt with a pulsatile profile of peak flow velocity of 1.5 m/sec. Both Grs. had comparable B.W. (mean ± SD, 1.0 ± 0.2 vs. 1.0 ± 0.3 kg), gest, age (28 ± 3 vs. 27 ± 3 wks) and cardiac Echo at time of study. See table I and table II: (* p< .05, **p< .01)

Table 1 No caption available
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Table 2 No caption available
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Gr. II required less doses of Ind. and had lower incidence of decreased urine output (u/o) and GI bleeding than Gr II. We concluded that Echo flow pattern can be used as an indicator for Ind. therapy to decrease the doses, therapy reducing the Ind. associated complications.