ABSTRACT
Six preterm infants with PDA received 14 treatments with indomethacin 0.2 mg/kg intravenously. Auscultatory and echocardiographic assessment indicated closure of the duct in 2, partial closure in 2, and no effect in 2 infants. The mean serum concentration of indomethacin was: 15 min after the first injection 1 314 ng/ml, after 1 hour 970 ng/ml, after 6 hours 718 ng/ml, and after 24 hours 388 ng/ml. The mean half-life of indomethacin in the serum was 20 hours (range 9-50 hours). Side effects in all infants were hyponatraemia, decreased urinary output, decreased urinary sodium excretion, and weight gain. One infant had transient thrombocytopenia and gastrointestinal haemorrhage. By intravenous administration of indomethacin in a dose of 0.2 mg/kg to preterm infants a sufficiently high serum concentration is obtained shortly after the injection. To maintain a high serum concentration for a longer period it is recommended to give a second dose of 0.2 mg/kg after 6 hours and if necessary a third dose of 0.1 mg/kg 24 hours after the first dose.
Subject(s)
Ductus Arteriosus, Patent/blood , Indomethacin/blood , Infant, Premature, Diseases/blood , Ductus Arteriosus, Patent/drug therapy , Half-Life , Humans , Indomethacin/administration & dosage , Infant, Newborn , Infant, Premature, Diseases/drug therapy , Injections, Intravenous , KineticsABSTRACT
Contrast echocardiographic studies were performed in two neonates. Glucose injections through umbilical arterial catheters demonstrate that the descending thoracic aorta is in close contact with the left atrial posterior wall (LAPW) and with the atrioventricular junction. The recognition of this particular part of LAPW is extremely important since it shows that the ultrasound beam is not in the standard direction. Probably the left atrium cannot so easily expand in that direction. Consequently, the left atrial dimension should not be measured here for the purpose of controlling variations in left atrium dilatation.
Subject(s)
Aorta, Thoracic , Echocardiography , Heart Atria , Infant, Newborn , HumansSubject(s)
Echocardiography , Heart Defects, Congenital/diagnosis , Diagnosis, Differential , Female , Humans , Infant, Newborn , MaleABSTRACT
Thirty-one patients with cystic fibrosis of varying severity were examined by echocardiography. Right ventricular dimension (RVD) was above upper normal limit in 14 patients and right ventricular dimension index (RVD index) was higher than the upper normal limit in 11 patients. Furthermore, there was a significant relationship between increasing RVD index and 1) decreasing forced vital capacity (FVC) both actual test results and average 6 months values; and 2) decreasing peak-expiratory flow rate (PEFR) both actual test results and average 6 months values. This observation suggests a persistent heart involvement. Five patients had either heart failure and/or electrocardiographic evidence of right ventricular abnormality. These patients had increased RVD index and one patient with the highest RVD index died 8 weeks after the examination. The present study has shown the usefulness of echocardiographic measurement of right ventricular dimension and of septal motion in assessing cor pulmonale, before development of electrocardiographic abnormalities and right heart failure.