Early intravenous indomethacin prolongs respiratory support in very low birth weight infants.

Infants weighing 1500 g at birth requiring either intermittent positive pressure ventilation or continuous positive airway pressure by 12 hours of age were entered in a randomized double blind controlled trial to test the efficacy of early intravenous indomethacin therapy in preventing chronic pulmonary disease of prematurity. Of the 30 newborns enrolled, 15 were treated with indomethacin and 15 were treated with placebo at 12, 24 and 36 hours of age. The groups were similar for birth weight, gestational age, sex, hyaline membrane disease and intracranial hemorrhage. Infants in the placebo group were successfully weaned from intermittent positive pressure ventilation at an earlier age than infants in the indomethacin group (p less than 0.05). Furthermore, chronic pulmonary disease of prematurity was similar in the two groups despite a reduction in the incidence of patent ductus arteriosus in the indomethacin group.