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Association between changes in urine output and successful indomethacin treatment for patent ductus arteriosus in preterm neonates
Author(s) -
Louis Deepak,
Dey Arjun,
Jain Amish
Publication year - 2021
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.15266
Subject(s) - medicine , ductus arteriosus , oliguria , urine , urine output , gestational age , anesthesia , incidence (geometry) , gestation , pregnancy , renal function , physics , biology , optics , genetics
Aim To investigate the relationship between changes in urine output during indomethacin treatment and ductal closure in preterm neonates. Methods It is a retrospective study in neonates ≤32 weeks who had received two courses of indomethacin for PDA treatment over a 5‐year period. Indomethacin courses with pre‐ and post‐echocardiography confirmation of PDA status were included. Various urine output indices were collected and compared between successful versus unsuccessful indomethacin courses. Indomethacin treatment success was defined as: (i) where PDA closed or became haemodynamically insignificant (hisPDA) after treatment and (ii) only including neonates where PDA had complete closure after treatment. ROC analysis was performed to examine predictive ability of urine output during indomethacin for treatment success. Results One hundred and eight indomethacin courses (first course: 52, second course: 56) in 80 neonates were included. The mean gestational age and birthweight were 25.4 ± 1.3 weeks and 762 ± 165 g, respectively. Irrespective of the definition used, there was no significant differences seen in any of urine output parameters between groups, except for a higher urine output during indomethacin associated with complete PDA closure (3.6 ± 1.3 vs. 3.0 ± 1.0 mL/kg/h, P = 0.02). The incidence of significant oliguria, hyponatraemia and need to withhold/delay indomethacin doses were also similar across groups. Conclusion Urine output was not a useful predictor of ductal response to indomethacin treatment in preterm neonates.