Indomethacin prophylaxis, patent ductus arteriosus, and the risk of bronchopulmonary dysplasia: Further analyses from the Trial of Indomethacin Prophylaxis in Preterms (TIPP) - 10/08/11
, Robin S. Roberts, MSc, Avroy Fanaroff, MD, Peter Davis, MD, Haresh M. Kirpalani, MD, MSc, Chuks Nwaesei, MD, Michael Vincer, MDTIPP Investigators
Reprint requests: Dr. Barbara Schmidt, McMaster University, HSC-3N11E, 1200 Main Street West, Hamilton, Ontario L8N 3Z5, Canada.Résumé |
Objectives |
To determine the risk of bronchopulmonary dysplasia (BPD) in subgroups of infants with and without patent ductus arteriosus (PDA) who were randomized to indomethacin prophylaxis or placebo, and to examine whether adverse drug effects on edema formation and oxygenation may explain why indomethacin prophylaxis does not reduce BPD.
Study design |
We studied 999 extremely low birth weight infants who participated in the Trial of Indomethacin Prophylaxis in Preterms (TIPP) and who survived to a postmenstrual age of 36 weeks.
Results |
The incidence of BPD in the 2 subgroups of infants with PDA was 52% (55/105) after indomethacin prophylaxis and 56% (137/246) after placebo. In contrast, rates of BPD in the 2 subgroups without a PDA were 43% (170/391) after indomethacin prophylaxis and 30% (78/257) after placebo (P [interaction] = .015). Logistic regression analysis with adjustment for prognostic baseline factors showed that adverse and independent effects of indomethacin prophylaxis on the need for supplemental oxygen and on weight loss by the end of the first week of life may increase the risk of BPD in infants without PDA.
Conclusions |
Harmful side effects on oxygenation and edema formation may explain why indomethacin prophylaxis does not prevent BPD even though it reduces PDA.
Le texte complet de cet article est disponible en PDF.Abbreviations : BPD, ELBW, FiO2, PDA, SD, TIPP
Plan
| Funded by the Medical Research Council of Canada (grant MT-13288). The US centers were supported in part by NICHD (grants U10 HD21364, U10 HD27851, U10 HD21373, U10 HD27881; M01 RR 00997, U10 HD27880; M01 RR 00070, U10 HD21385, U10 HD27904, and U10 HD34216). The INDOCID PDA was donated by Merck Frosst. |
Vol 148 - N° 6
P. 730 - juin 2006 Retour au numéro
Article précédent
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