Patent ductus arteriosus (PDA) in premature infants is a current challenge to
pediatricians. Pharmacological closure of PDA with indomethacin, a prostaglandin synthetase
inhibitor is an effective drug therapy, along with usual medical treatment. Administration
of indomethacin may decrease mortality and morbidity (e.g. bronchopulmonary dysplasia)
among very small premature infants (< 1,000 g). Co-administration of furosemide with
indomethacin may lessen the transient renal side effects of indomethacin. The therapeutic
efficacy of indomethacin in closure of PDA depends largely on understanding and manipulation
of the pharmacokinetic characteristics of the drug in preterm infants. Maintaining a
therapeutic level of the drug in plasma is essential to achieve an optimal therapeutic
response. Compared to surgical ligation, indomethacin is a noninvasive, less expensive and
safer therapy for ductus closure.
Our study establishes the following hierarchy of cardiovascular risk factors as predictors of PVD: hypertension, cardiovascular disease, hyperlipidemia, diabetes, tobacco use, obesity, stroke.
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