Hypertension in a preterm after indomethacin use for patent ductus arteriosus

抄録

Non-steroidal anti-inflammatory drugs have been associated with hypertension in adults. We report an infant who developed hypertension after indomethacin use for patent ductus arteriosus. The patient was delivered at 31 weeksʼ gestation. Patent ductus arteriosus was detected on day 2. Indomethacin was given intravenously from day 2 to day 6. The ductus arteriosus was closed on day 7. On day 8, urine output decreased and serum creatinine increased. With fluid restriction, however, body weight remained the same from day 7 to day 14. Blood pressure increased to 82/41 mmHg on day 13 and became 90/58 mmHg on day 14 despite an increase in urine output. Cardiac ultrasonography suggested high afterload. With the use of nitroglycerin, blood pressure normalized on day 17. While non-steroidal anti-inflammatory druginduced hypertension in adults has been ascribed to renal vasoconstriction and resultant sodium retention, the major cause of hypertension in our case was thought to be high afterload due to increased peripheral vascular resistance presumably secondary to decreased synthesis of prostaglandin I₂.