A single very early dexamethasone dose improves respiratory and cardiovascular adaptation in preterm infants
| Autor: | Donald Holbert, Suzanne E Hegemier, Arthur E. Kopelman, Alicia A. Moise |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Male
Postnatal Care Time Factors Randomization Neonatal intensive care unit genetic structures medicine.drug_class Anti-Inflammatory Agents Blood Pressure Infant Premature Diseases Peak inspiratory pressure Dexamethasone Cerebral Ventricles Cardiovascular Physiological Phenomena Cause of Death medicine Humans Single-Blind Method Prospective Studies Respiratory system Cerebral Hemorrhage business.industry Infant Newborn medicine.disease Adaptation Physiological Intraventricular hemorrhage Bronchopulmonary dysplasia Anesthesia Pediatrics Perinatology and Child Health Respiratory Physiological Phenomena Corticosteroid Female business medicine.drug |
| Zdroj: | The Journal of Pediatrics. 135:345-350 |
| ISSN: | 0022-3476 |
| Popis: | To test the hypothesis that a single dose of dexamethasone given soon after delivery to infants28 weeks' gestation leads to improved cardiopulmonary adaptation in the first week and lowers the risk of significant intraventricular hemorrhage.In a prospective, blinded, placebo-controlled study, we randomly assigned 70 infants28 weeks' gestation who were born in the hospital to receive dexamethasone (0.2 mg/kg) (n = 37) or normal saline solution (n = 33) within 2 hours of delivery. After an interim analysis showed that the incidence of intraventricular hemorrhage was much lower than expected, enrollment was stopped and we limited our analysis to a comparison of ventilator settings, blood pressure, and pressor use during the first 7 days.Clinical characteristics of the groups were comparable at study entry. Ventilator weaning occurred more rapidly in the patients who received dexamethasone: their intermittent mandatory ventilation rate was significantly lower on days 1 through 6, and their peak inspiratory pressure was lower on days 3 through 7 compared with the control group. Mean blood pressures were higher in the dexamethasone group within 12 hours and remained higher through day 5, but the use of pressors was not different. Fewer infants in the dexamethasone group received indomethacin to treat a patent ductus arteriosus (22% vs 47%, P.03).Dexamethasone given within 2 hours of delivery to preterm infants28 weeks' gestation resulted in lower ventilator settings and higher mean blood pressures during the first 7 days. Fewer infants required indomethacin to treat a patent ductus arteriosus. |
| Databáze: | OpenAIRE |
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