Reduction in blood glucose values following indomethacin therapy for patent ductus arteriosus

Purpose: To evaluate the effects of indomethacin on blood glucose Values in premature infants with patent ductus arteriosus (PDA). Methods: Twenty-five very low birthweight infants with PDA were given 0.2 m g/kg, i.v., indomethacin for up to three doses. We examined the relationshi p between blood glucose values and glucose infusion rate before and after i ndomethacin therapy. Results: There was a significant reduction in blood glucose values between 12 and 96 h following i.v. indomethacin therapy. Eleven of 25 infants (44%) had blood glucose values below 40 mg/dL between 12 and 60 h (mean 32.7 h) after the initial dose. Although the glucose infusion rate during the first 12 h was constant (3.56 +/- 0.98 mg/kg per min), the blood glucose values decreased from 96 +/- 32 mg/dL at the starting point to 75 +/- 29 mg/dL at 12 h (P < 0.05). The maximum blood glucose reduction was 51.6 +/- 34.7 mg/d L and the maximum blood glucose reduction rate was 50.4 +/- 20.2%. Conclusions: The results suggest that blood glucose values should be measur ed at least every 6 h for 72 h until they stabilize in order to prevent une xpected hypoglycemia.