Van Bel F, Van de Bor M, Stijnen T, Baan J, Ruys J H
Department of Pediatrics, University Hospital, Leiden, The Netherlands.
Pediatrics. 1989 Nov;84(5):802-7.
Indomethacin decreases cerebral blood flow velocity and blood flow in the preterm infant. The duration of this negative effect has not been established. Cerebral blood flow velocity was evaluated in 24 preterm infants with symptomatic patent ductus arteriosus before and during the first 12 hours after a single intravenous dose of indomethacin, 0.1 mg/kg. Cerebral blood flow velocity was estimated by serial Doppler investigations of the anterior cerebral arteries. Indomethacin administration led to an instantaneous decrease of peak systolic flow velocity, temporal mean flow velocity, and end-diastolic flow velocity of the anterior cerebral arteries in all infants, which was maximal between 2 and 40 minutes after indomethacin administration and was followed by a more sustained recovery of all velocities to baseline values. Temporal mean flow velocity was not different from pre-indomethacin values at 3 hours after the administration. It is concluded that indomethacin can impact the cerebral circulation of the preterm infant for at least 2 hours. This may have consequences in preterm infants with unstable hemodynamics and pulmonary function.
吲哚美辛可降低早产儿的脑血流速度和血流量。这种负面影响的持续时间尚未确定。对24例有症状的动脉导管未闭早产儿在单次静脉注射0.1mg/kg吲哚美辛之前及之后的12小时内进行了脑血流速度评估。通过对大脑前动脉的系列多普勒检查来估计脑血流速度。在所有婴儿中，吲哚美辛给药导致大脑前动脉的收缩期峰值流速、时间平均流速和舒张末期流速即刻下降，在吲哚美辛给药后2至40分钟时降至最大，随后所有流速更持续地恢复至基线值。给药后3小时的时间平均流速与给药前的值无差异。结论是，吲哚美辛可至少在2小时内影响早产儿的脑循环。这可能对血流动力学和肺功能不稳定的早产儿产生影响。
