We had a 23 weeker on our unit and an MD prescribed two rounds of Indomethacin as a prophylais for IVH for this kiddo. I read the research that was done in 1988 and I wasn't completely convinced by the research article on the validity of Indocin as prophylaxis for IVH. I certainly did not feel that is showed enough evidence to base clinical practice on. Of course the kid that got the multiple rounds of Indocin perfed, but I have to say, hasn't had IVH. Does anyone else use Indomethacin on their unit as prophylaxis for IVH? Does anyone know of more research or has a more solid understanding of why Indocin should be used a prophylaxis for IVH? The research article did mention that Indocin causes reduced blood flow to the brain, there-by reducing pressures and decreasing risk and incidence of IVH. But at what cost and really how effectively? Effectively enough to risk perfing? Thoughts????