Comparison of Intravenous and Enteral Indomethacin Administration for Closure of Patent Ductus Arteriosus in Extremely-low-birth-weight Infants

Background: The objective of this retrospective cohort study was to compare the patent ductus arteriosus (PDA) closure rate with different routes (intravenous and enteral) of indomethacin treatment and neonatal outcomes. Methods: Infants with a birthweight < 1,000 g born between July 1997 and June 2007 at Taipei Veterans General Hospital and who received indomethacin treatment for PDA were included in the study. Outcome measures were ductal closure rate and neonatal outcomes. Results: Of 41 extremely-low-birth-weight infants with PDA, 3 infants had spontaneous closure and 3 died before treatment. Of the remaining 35 infants, 13 received enteral ethanol solution of indomethacin and 22 received the intravenous (IV) form. The total closure rates of the IV and enteral groups were 81.8% and 76.9%, respectively. There were no significant differences in the incidence of impaired renal function, necrotizing enterocolitis, chronic lung disease or severe retinopathy of prematurity between the 2 groups. Conclusion: Our results suggest that ethanol-based indomethacin is an effective alternative to IV indomethacin for the pharmacological closure of PDA in extremely-low-birth-weight infants.