Prophylactic indomethacin for prevention of intraventricular hemorrhage in premature infants

Emmalee S Bandstra, B. M. Montalvo, R. N. Goldberg, I. Pacheco, P. L. Ferrer, J. Flynn, J. B. Gregorios, Eduardo Bancalari

Research output: Contribution to journalArticle

107 Citations (Scopus)

Abstract

The impact of early prophylactic use of intravenous indomethacin on the incidence and severity of periventricular-intraventricular hemorrhage and patent ductus arteriosus in 199 oxygen-requiring premature infants (≤ 1300 g birth weight) was prospectively investigated. The trial was controlled, the infants were randomized, and the investigators were unaware of the group assignments. Patients with minimal (grade I) or no periventricular-intraventricular hemorrhage determined by prestudy echoencephalography were randomized within two birth weight subgroups (500 to 899 and 900 to 1300 g) to receive either prophylactic indomethacin (n = 99) or an equal volume of saline-vehicle placebo (n = 100). The first dose (0.2 mg/kg) was given within 12 hours of delivery and two subsequent doses (0.1 mg/kg) were administered at 12 hourly intervals. Prophylactic indomethacin significantly reduced the incidence of grades II to IV periventricular-intraventricular hemorrhage. Intraventricular hemorrhage was half as common in infants given prophylactic indomethacin as in control infants (23% v 46%, P < .002). The reduction was manifested in both birth weight subgroups. Results of this study also confirmed a lower incidence of clinically significant patent ductus arteriosus in infants who received prophylactic indomethacin in contrast to those who received placebo (11% v 42%, P < .001). No significant differences were found between treatment and control groups in the duration of oxygen therapy, mechanical ventilation, or hospitalization or in the incidence of pneumothorax, chronic lung disease, sepsis, necrotizing enterocolitis, retinopathy of prematurity, or death. Early prophylactic indomethacin initiated within 12 hours of delivery is effective in reducing the incidence of intraventricular hemorrhage as well as clinically significant patent ductus arteriosus in very low birth weight premature infants.

Original languageEnglish
Pages (from-to)533-542
Number of pages10
JournalPediatrics
Volume82
Issue number4
StatePublished - Jan 1 1988

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Premature Infants
Indomethacin
Hemorrhage
Patent Ductus Arteriosus
Birth Weight
Incidence
Echoencephalography
Placebos
Oxygen
Retinopathy of Prematurity
Necrotizing Enterocolitis
Very Low Birth Weight Infant
Pneumothorax
Artificial Respiration
Lung Diseases
Sepsis
Hospitalization
Chronic Disease
Research Personnel
Control Groups

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Bandstra, E. S., Montalvo, B. M., Goldberg, R. N., Pacheco, I., Ferrer, P. L., Flynn, J., ... Bancalari, E. (1988). Prophylactic indomethacin for prevention of intraventricular hemorrhage in premature infants. Pediatrics, 82(4), 533-542.

Prophylactic indomethacin for prevention of intraventricular hemorrhage in premature infants. / Bandstra, Emmalee S; Montalvo, B. M.; Goldberg, R. N.; Pacheco, I.; Ferrer, P. L.; Flynn, J.; Gregorios, J. B.; Bancalari, Eduardo.

In: Pediatrics, Vol. 82, No. 4, 01.01.1988, p. 533-542.

Research output: Contribution to journalArticle

Bandstra, ES, Montalvo, BM, Goldberg, RN, Pacheco, I, Ferrer, PL, Flynn, J, Gregorios, JB & Bancalari, E 1988, 'Prophylactic indomethacin for prevention of intraventricular hemorrhage in premature infants', Pediatrics, vol. 82, no. 4, pp. 533-542.
Bandstra ES, Montalvo BM, Goldberg RN, Pacheco I, Ferrer PL, Flynn J et al. Prophylactic indomethacin for prevention of intraventricular hemorrhage in premature infants. Pediatrics. 1988 Jan 1;82(4):533-542.
Bandstra, Emmalee S ; Montalvo, B. M. ; Goldberg, R. N. ; Pacheco, I. ; Ferrer, P. L. ; Flynn, J. ; Gregorios, J. B. ; Bancalari, Eduardo. / Prophylactic indomethacin for prevention of intraventricular hemorrhage in premature infants. In: Pediatrics. 1988 ; Vol. 82, No. 4. pp. 533-542.
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