PEDIATRICS Vol. 86 No. 1 July 1990, pp. 147
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Why Use Indomethacin?

FRANK VAN BEL MD1, MARGOT VAN DE BOR MD1, THE STIJNEN PHD1, JAN BAAN PHD1, and JAN H. RUYS MD1

1 Department of Pediatrics, Neonatal Unit, University Hospital of Leiden, Leiden, The Netherlands

In Reply.—

We are very grateful for the commentary by Dr Rosenfeld on our article1 and share his concern about the possible adverse effects of indomethacin in sick and compromised preterm neonates.

We have some indication that the acute systemic effect of indomethacin (an increase in peripheral vascular resistance) also has an acute effect on ductal tissue. In most of the infants we observed, a negative diastolic flow velocity in the anterior cerebral artery existed before indomethacin treatment, suggesting a ductal steal phenomenon.