A controlled trial of human surfactant replacement therapy for severe respiratory distress syndrome in very low birth weight infants

1990 ◽  
Vol 116 (2) ◽  
pp. 295-300 ◽  
Author(s):  
Michael J. Lang ◽  
Robert T. Hall ◽  
Nallu S. Reddy ◽  
C. Gay Kurth ◽  
T. Allen Merritt
Keyword(s):  
Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Very Low Birth Weight ◽  
Controlled Trial ◽  
Low Birth Weight Infants ◽  
Severe Respiratory Distress ◽  
Surfactant Replacement Therapy ◽  
Severe Respiratory Distress Syndrome

Passage of the First Stool in Very Low Birth Weight Infants

PEDIATRICS ◽  
1987 ◽  
Vol 79 (6) ◽  
pp. 1005-1007
Author(s):  
Meenakshi K. Jhaveri ◽  
Savitri P. Kumar
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Very Low Birth Weight ◽  
Gut Hormones ◽  
Low Birth Weight Infants ◽  
Severe Respiratory Distress ◽  
Severe Respiratory Distress Syndrome

Times of first stool passage were studied in 171 infants who weighed less than 1,500 g at birth. Delayed passage (greater than 48 hours) was noted in 20.4% of this group. Significant differences were noted between the delayed and nondelayed groups for gestational age, presence of severe respiratory distress syndrome, and the time of the first enteral feeding. In very low birth weight infants, delay in the passage of the first stool is a common occurrence. This delay is probably due to physiologic immaturity of the motor mechanisms of the gut, lack of triggering effect of enteral feeds on gut hormones, and the presence of severe respiratory distress syndrome, which may singly or in concert adversely affect gastrointestinal motility.

CONTROLLED TRIAL OF INTENSIVE CARE FOR VERY LOW BIRTH WEIGHT INFANTS

PEDIATRICS ◽  
1971 ◽  
Vol 48 (5) ◽  
pp. 711-714
Author(s):  
W. H. Kitchen ◽  
D. G. Campbell
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Mortality Rate ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Very Low Birth Weight ◽  
Controlled Trial ◽  
Arterial Oxygen ◽  
Low Birth Weight Infants

Two controlled clinical trials were carried out in infants with a birth weight between 1,000 and 1,500 gm. Careful control of arterial oxygen and the infusion of 10% glucose for the first 3 days of life failed to reduce the mortality rate in a group of 118 infants. In the second clinical trial involving 120 patients, the mortality rate was reduced, especially in infants with clinical evidence of respiratory distress syndrome, by the addition to the regime of early vigorous efforts to correct acidosis. The mortality in comparable infants before the introduction of intensive care in 1965 was 49%. In the era of intensive care, 35% of patients given only routine care died, whereas infants receiving vigorous intensive care had a mortality rate of only 18%. The patients with respiratory distress syndrome showed the most noticeable improvement in survival.

A Controlled Trial of Dexamethasone to Prevent Bronchopulmonary Dysplasia in Surfactant-treated Infants

PEDIATRICS ◽  
1996 ◽  
Vol 98 (2) ◽  
pp. 204-210 ◽  
Author(s):  
Alok Rastogi ◽  
Subuola M. Akintorin ◽  
Michelle L. Bez ◽  
Pablo Morales ◽  
Rosita S. Pildes
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Bronchopulmonary Dysplasia ◽  
Distress Syndrome ◽  
Very Low Birth Weight ◽  
Controlled Trial ◽  
Low Birth Weight Infants ◽  
Dexamethasone Therapy

Background. Surfactant therapy now has a well-established role in the treatment of neonates with respiratory distress syndrome but has failed to reduce the incidence of bronchopulmonary dysplasia (BPD). We conducted a double-blind, placebo-controlled trial to test the hypothesis that dexamethasone therapy given during the first 12 days of life to very low birth weight infants would be synergistic to surfactant in preventing BPD. Methods. Seventy surfactant-pretreated infants (700-1500 g) who had severe respiratory distress syndrome (a/A ratio, 0.18 ± 0.10; mean airway pressure, 11.1 ± 1.9 cm H2O; fraction of inspired oxygen, 0.81 ± 0.22) were enrolled to receive a 12-day course of dexamethasone (n = 36) or saline placebo (n = 34) starting within the first 12 hours after birth. The starting dose of dexamethasone was 0.5 mg/kg per day, and it was tapered progressively. Results. Ventilator variables at 5 to 14 days were significantly improved in those infants who received dexamethasone compared with those who received the placebo. The effect seem to be more marked in infants weighing less than 1250 g at birth. Significantly more infants could be extubated by 14 days of age in the dexamethasone group (26 of 32 vs 14 of 32). Dexamethasone therapy reduced the incidence of BPD at 28 days (odds ratio, 0.1; 95% confidence interval, 0.03 to 0.3) and eliminated BPD at 36 weeks' postconceptional age. Dexamethasone-treated infants had greater weight loss at 14 days (12.9 ± 6.4% vs 3.7 ± 8.6%, respectively) and higher blood pressures from days 3 to 10. However, no differences were seen in time to regain birth weight, hypertension (1 infant in each group), or incidence of intraventricular hemorrhage. Conclusions. We found an additive effect between dexamethasone and surfactant in improving pulmonary status and reducing the incidence of BPD. Compared with the placebo, dexamethasone therapy was more effective in reducing the incidence of BPD in surfactantpretreated very low birth weight infants.

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