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Discussion

treating a PDA

Anyone experiences with treating a duct with either indocid or ibuprofen?

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We use indo fairly often. None of my patients have had any problems with it other than transient decreased urinary output.

We use indo alot. I think it helps most of the time. We start with 2 doses at 12 hour interval and if that is not enough to close the ductus we give another one 12-24 hours after the second one.

We rarely have any problems related to the indometacin.

  • Experts

This has been very well documented in the literature, I believe, and I just checked Merenstein, 5th edition, p 585.

You might want to look in Neofax as well. Pay close attention to the side effects--there are significant risks, i.e., IVH, but that still beats the heck out of surgical treatment.

  • Author

In Europe we often don't use indocid anymore due to the side effects - we now use ibuprofen..same result but side effects are not that bad, well, considering renal problems. I sometimes wonder anyway what sort of drugs 're given and not tested or even recommended for children (we don't talk about prems). Is it the same in other countries? I wonder...

I think the most sinificant finding is the decrease in IVH or at least in severity of it. That and the fact that it's probably hella cheaper makes me wish we'd try it at my hospital!

We've used indocin for years to treat PDA's. One the nurses' biggest concerns/side effects is an increase in feeding intolerance, specifically NEC. Our babies are screened for low plt counts but few of the attendings want to make infants NPO during treatment. It always makes me nervous to give it to a premie on feedings.

Indocin here too. We give it Q12hours for three doses. We check plts before each dose. All kids are NPO for 24 hours at least (yes, I have seen kids perf from Indocin...not a pretty site). Also, we give ours over a pump for 30 minutes....until about 5 years ago we pushed it :eek:

I don't believe ibuprofin has been FDA approved here yet.

  • Author

Thank you so much for your replies. It's always interesting for me to see how different things're done in other countries. Ipuprofen is given in 3 doses over 15 minutes. It doesn't interfere in feedings as bad as indocid so we can continue feedings as usual.

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