Key result
Indomethacin treatment for patent ductus arteriosus significantly increased long-term heart rate variability, most markedly in infants with improved ventilation (from 1.5 to 3.2; p<0.01).
Why the study?
Does indomethacin treatment for closure of patent ductus arteriosus improve long-term variability of heart rate in preterm infants?
Observational (n=59)
Does indomethacin treatment for closure of patent ductus arteriosus improve long-term variability of heart rate in preterm infants?
p-value: p=<0.01
Long-term variability of heart rate increases with successful closure of PDA and may serve as a useful tool to monitor treatment and brain stem oxygenation in preterm infants.
LTV may aid noninvasive PDA assessment in preterms; leaves open utility for guiding therapy or outcomes.
Long-term variability (LTV) of heart rate was calculated continuously by a microprocessor in 25 preterm infants undergoing indomethacin treatment for closure of patent ductus arteriosus (PDA), in 24 preterm infants without signs of PDA, and in 10 neonates treated with prostaglandin E1 for cyanotic heart malformation. In infants with patent ductus arteriosus, LTV was lower than in controls. Following indomethacin, LTV increased most markedly (from 1.5 to 3.2; p less than 0.01) in infants with improved ventilation. The increase was less marked (from 1.8 to 2.5; p less than 0.05) in infants whose degree of respiratory failure did not change. LTV remained largely unchanged in infants who deteriorated. In 9 out of the 10 neonates treated with prostaglandin E1, LTV increased. We conclude that LTV corresponds to brain stem oxygenation and may be a useful tool to monitor treatment of PDA.
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Prietsch et al. (2009) conducted an observational in Patent ductus arteriosus (n=59). Indomethacin and Prostaglandin E1 vs. Preterm infants without PDA was evaluated on Long-term variability (LTV) of heart rate (p=<0.01). Indomethacin treatment for patent ductus arteriosus significantly increased long-term heart rate variability, most markedly in infants with improved ventilation (from 1.5 to 3.2; p<0.01).
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