Failure of indomethacin to close persistent ductus arteriosus in infants weighing under 1000 grams.

In Vivo Constriction of the Ductus Arteriosus by Nonsteroidal Antiinflammatory Drugs in Near-Term and Preterm Fetal Rats

“…Since the introduction of indomethacin therapy for patent ductus arteriosus in premature infants (20,21), factors related to the failure of indomethacin to close the patent ductus have been analyzed. There is some evidence showing that infants with a very low birth weight showed only a transient response to indomethacin, or none at all (22,23). The oxygen environment of the ductus tissue in these infants is much higher than in fetal DA.…”

Management of Symptomatic Patent Ductus Arteriosus in Very Low-Birth-Weight Infants

“…The response to indomethacin is reported to be influenced by gestational age, birth weight, postnatal age, and postconceptional age, as well as adequate plasma levels of the drug [14][15][16][17][18]. Indomethacin, in the treatment of patent ductus arteriosus, has been well studied and no major complications have been reported [19,20].…”

Variation in the diagnosis and management of patent ductus arteriosus in premature infants

“…With a failure rate of 20% to 40% in PDA closure by indomethacin (18,(46)(47)(48), surgical ligation has been used as alternative therapy (5,18). However, a randomized, controlled clinical trial in 1987 (49) found that infants who had surgical ligation instead of indomethacin spent less time on ventilation, required fewer medications, had central venous lines removed earlier and were able to maintain appropriate feeds earlier.…”