1 Division of Neonatal-Perinatal Medicine, Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas
To the Editor.
The recent article by Van Bel et al1 on the effects of indomethacin on cerebral blood flow velocity was extremely interesting, especially the suggestion that there may have been substantial cardiovascular effects of this cyclooxygenase inhibitor that were independent of its effects on prostaglandin synthesis. Furthermore, their hypothesis that the reduction in heart rate also provided indirect evidence for a systemic effect, ie, an increase in peripheral vascular resistance and a decrease in cardiac output, should be of interest to all neonatalogists using this drug, especially in sick or compromised neonates.