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Prostaglandins have been reported to play an important role in endotoxic shock. However, the beneficial effects of prostaglandin synthesis inhibitors for the treatment of newborn endotoxic shock have been controversial. This study was performed to evaluate the effects of indomethacin on the hemodynamics during fulminant endotoxic shock in newborn dogs. After E. coli lipopolysaccharide (LPS) injection, mean arterial pressure was maintained for the first 60 min, and then declined from 53 +/- 2 to 27 +/- 2 mmHg at 120 min. Cardiac output dropped from 0.37 +/- 0.03 to 0.24 +/- 0.03 L/min/kg 5 min after LPS injection and continued to decline to 0.12 +/- 0.01 L/min/kg at 120 min. Indomethacin treatment 20 min prior to LPS injection attenuated the hypotension (50 +/- 3 mmHg at 120 min, p less than 0.05) and the decrease of cardiac output (0.18 +/- 0.02 L/min/kg at 120 min, p less than 0.05). Indomethacin treatment 5 min after LPS injection also attenuated the hypotension (55 +/- 4 mmHg at 120 min, p less than 0.05) and the decrease of cardiac output (0.21 +/- 0.02 L/min/kg at 120 min, p less than 0.05). Survival times were increased by the indomethacin treatments. Thus, indomethacin appears to be beneficial for the treatment of fulminant hemodynamic deterioration in newborn endotoxic shock.

Indomethacin Treatment in Newborn Canine Endotoxic Shock.