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KMID : 0367219920090020225
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Sejong Medical Journal
1992 Volume.9 No. 2 p.225 ~ p.232
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Treatments in Premature Infants with Patent Ductus Arteriosus -Pontal-
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Abstract
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Patent ductus arteriosus (PDA) is a common disease in premature infants. the incidence is inversely related to the gestational age and birth weight. Hemodynamically significant PDA increases the morbidity and mortality of premature infants. So
the
treatment of PDA in one of the major problems in neonatal intensive care unit.
In 1976, since the indomethacin, prostaglandin synthetase inhibitor (PSI). was introduced to close the PDA of premature infants. several studies have been reported the effect of indomethacin on PDA of premature infants. On the base of the same
mechanism
as indomethacin, in 1984, Pontal (Mefenamic acid). Another agent of PSI, was introduced to close the PDA of premature infants. Pontal is manufactured with syrup and easy to administer the more accurate dosage per oral and has the same effects as
indomethacin.
The purpose of this study was to investigate the treatments of PDA in premature infants and evaluate the responses of PDA to Pontal and observe the complications of Pontal.
From January 1990 to September 1990, 33 premature infants was diagnosed with significant PDA based on the clinical and echocardiographic findings in NICU at Department of Pediatrics, Hanyang Universtiy Hospital.
The results obained were as follows:
1. The closure rate of PDA was 30.0% in fluid restriction only. 0% in Lasix Administration 0% in Indomethacin administration and 47.1% in Pontal administration.
2. The relation between clinical course and PDA results were observed. Among 10 cases of fluid restriction only, 3 cases were closed and 2 cases of these were survivd, 7 cases were not closed and 4 cases of these were survived. Among 17 cases of
Pontal
treatment group. 8 cases were closed and 7 cases of these were survived, 9 cases were not closed and only 2 cases of these were survived.
3. Closure rates of PDA by Pontal treatment were not significantly related to gestational age. birth weight. Apgar score, sex, hyaline membrane disease, the time and number of administration.
4. Urine output significantly fell from 38.2±±11.7 to 20.5±12.8ml per 8 hours before and after Pontal administration with p-value 0.0002 but neither serum BUN. creatinine nor Sodium were altered significantly before and after Pontal
administration.
We concluded that PDA in premature infants should be closed for survival and for this Pontal administration can be choiced to the first method of treatment.
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