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Indomethacin Therapy for Patent Ductus Arteriosus

William N. Evans, MD; Kathleen A. Cass, MD, PHD; Bernard H. Feldman, MD
Am J Dis Child. 1987;141(10):1042. doi:10.1001/archpedi.1987.04460100020014.
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Sir.—In their recent report in AJDC, Ramsay et al1 found a 58% closure rate in 19 premature infants with respiratory distress syndrome (RDS) who underwent indomethacin therapy for a patent ductus arteriosus proved by two-dimensional and pulsed Doppler echocardiographic studies. Furthermore, they reported an eventual surgical ligation rate of 50%. They concluded that the low response rate observed might have resulted from relatively late (mean age of patients, 7 days) indomethacin treatment.

In our neonatal intensive care unit between November 1984 and November 1986, 100 premature infants with RDS and a patent ductus arteriosus proved by two-dimensional Doppler echocardiographic studies underwent medical therapy with indomethacin. We analyzed the total number of indomethacin courses (utilizing the intravenous preparation at standard recommended dosages). These 100 patients underwent a total of 116 indomethacin treatment courses. Our patients fell into two main groups by their response to indomethacin: patients weighing less than

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