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Effects of repeated indomethacin administration on cerebral oxygenation and haemodynamics in preterm infants: Combined near infrared spectrophotometry and Doppler ultrasound study

  • Neonatology
  • Original Paper
  • Published:
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Abstract

The objectives of this study were to evaluate the effect of repeated indomethacin administration on cerebral oxygenation in relation to changes in cerebral blood flow velocity (CBFV) and other relevant physiological variables. Fourteen preterm infants with patent ductus arteriosus were studied during three subsequent indomethacin bolus administrations with intervals of 12 and 24 h. Changes in concentration of oxyhaemoglobin (cO2Hb), deoxyhaemoglobin (cHHb) and oxidized cytochrome aa3 (cCyt.aa3) in cerebral tissue and changes in cerebral blood volume (CBV) were measured by near infrared spectrophotometry; changes in mean CBFV in the internal carotid artery were measured by pulsed Doppler ultrasound. Simultaneously heart rate, transcutaneouspO2 andpCO2, arterial O2 saturation and blood pressure were measured. All variables were continuously recorded until 60 min after indomethacin administration. Within 5 min after each indomethacin administration, significant decreases in CBFV, CBV and cO2Hb and cCyt.aa3 were observed which persisted for at least 60 min, while cHHb increased or did not change at all. There were no changes in the other variables recorded. These data demonstrate that indomethacin administration is accompanied by a reduction in cerebral tissue oxygenation due to decreased cerebral blood flow. Therefore, low arterial oxygen content, either caused by low arterial O2 saturation or by low haemoglobin concentration, may be a contraindication for indomethacin treatment in preterm infants.

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Abbreviations

CBF :

cerebral blood flow

CBFV :

cerebral blood flow velocity

CBV :

cerebral blood volume

cCyt.aa 3 :

oxidized cytochrome aa3 concentration

cHHb :

deoxyhaemoglobin concentration1

cO 2 Hb :

oxyhaemoglobin concentration1

ctHb :

total haemoglobin concentration1

NIRS :

near infrared spectrophotometry

PDA :

patent ductus arteriosus

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Authors and Affiliations

  1. Department of Paediatrics, University of Nijmegen, P.O. Box 9101, NL-6500 HB, Nijmegen, The Netherlands

    K. D. Liem, J. C. W. Hopman & L. A. A. Kollée

  2. Department of Physiology, University of Nijmegen, The Netherlands

    B. Oeseburg

Authors
  1. K. D. Liem
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  2. J. C. W. Hopman
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  3. L. A. A. Kollée
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  4. B. Oeseburg
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Liem, K.D., Hopman, J.C.W., Kollée, L.A.A. et al. Effects of repeated indomethacin administration on cerebral oxygenation and haemodynamics in preterm infants: Combined near infrared spectrophotometry and Doppler ultrasound study. Eur J Pediatr 153, 504–509 (1994). https://doi.org/10.1007/BF01957006

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  • DOI: https://doi.org/10.1007/BF01957006

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