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October 1982

Congenital Heart Disease and Respiratory Distress Syndrome: Reversal of Indomethacin Closure of Patent Ductus Arteriosus by Prostaglandin Therapy in a Preterm Infant

Author Affiliations

From the Divisions of Neonatal—Perinatal Medicine (Drs Strauss, Modanlou, and Wittner) and Radiology (Dr Gyepes), Miller Children's Hospital of Long Beach, University of California, Irvine.

Am J Dis Child. 1982;136(10):934-936. doi:10.1001/archpedi.1982.03970460064014

• Two relatively large premature newborn infants with respiratory distress syndrome and ductus-dependent congenital heart disease were treated. In one, pharmacologic closure of the ductus arteriosus resulted in severe hypoxemia. The patency of the ductus was reestablished with the infusion of alprostadil (PGE1), until palliative surgery was performed. In the second case, persistent pulmonary hypertension was clinically suspected, and pharmacologic therapy was initiated without adequate cardiac evaluation. In large premature infants with respiratory distress syndrome, closure of the ductus arteriosus should not be attempted before ruling out the presence of ductus-dependent congenital heart disease. Furthermore, pharmacologic closure of ductus arteriosus can be reversed by the infusion of prostaglandin.

(Am J Dis Child 1982;136:934-936)