EFFECTS OF EARLY INDOMETHACIN ADMINISTRATION ON OXYGENATION AND SURFACTANT REQUIREMENT IN LOW-BIRTH-WEIGHT INFANTS

A previous study found that early intravenous indomethacin administrat ion prolonged respiratory support in very Bow birth weight infants. We have, therefore, designed a randomized, double blind controlled study to evaluate the oxygenation, and surfactant requirements in preterm l ow birth weight infants receiving early indomethacin administration. P remature neonates who received surfactant therapy and on mechanical ve ntilation were prospectively randomized to receive either placebo or i ndomethacin (0.2 mg/kg intravenously at 12 postnatal hems and every 24 h for two more doses), Oxygenation was assessed by FiO(2) required an d arterial/alveolar oxygen (a/A O-2) ratio during the first 48 h of li fe, The doses of surfactant were compared between the two groups. Twen ty-seven infants (n = 14 of early indomethacin and n = 13 of placebo g roup) fulfilled inclusion criteria. At admission to the study, there w ere no differences in the birth weight, gestational age, sex, apgar sc ores, a/A O-2 ratio, and FiO(2). The control group exhibited a signifi cant improvement in oxygenation (FiO(2) requirement and a/A O-2 compar ed with the early indomethacin group at 24 (P = 0.026 and 0.02, respec tively) and 48 h of life (P = 0.037 and 0.026, respectively). The requ irement of surfactant was significantly larger in the early indomethac in group (P = 0.029). Early indomethacin administration increases oxyg en and surfactant requirement.