The Annals of thoracic surgery
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Indomethacin constricts the patent ductus arteriosus in approximately 70% of premature infants, but temporarily inhibits synthesis of all prostaglandins. Early toxicity of indomethacin is not prohibitive, but the possibility of late neurological deficits is raised by results of laboratory experiments. As yet, no late toxic effects of indomethacin have been observed. However, this possibility and the low morbidity (less than 2%) and mortality (less than 2%) of surgical ligation of the patent ductus arteriosus in premature infants favor operation except in carefully controlled and limited clinical trials.
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Autotransfusion following cardiopulmonary bypass has been used infrequently. Certain patients are noted for the potential of serious hemorrhage following conclusion of bypass. ⋯ It can be utilized for several minutes after the administration of protamine. Blood salvage can be considerable and at times lifesaving.