Leucine kinetics during simultaneously administered insulin and dexamethasone in preterm infants with severe lung disease.

The objective of this study was to determine whether insulin administration would prevent the well-documented catabolic effect of dexamethasone given to preterm infants with chronic lung disease. We studied leucine metabolism in 11 very-low-birth-weight infants before dexamethasone treatment and on d 2, 4, and 7 thereafter. During the first 4 d of dexamethasone, insulin was administered i.v. at a dose of 0.5 (n = 7) or 1.0 (n = 5) IU/kg/d. Leucine turnover was not significantly different between d 0 (337 +/- 41.3 micromol leucine/kg/h), d 2 (288 +/- 27.2 micromol leucine/kg/h), d 4 (302 +/- 22.1 micromol leucine/kg/h), and d 7 (321 +/- 21.2 micromol leucine/kg/h), and neither was leucine breakdown (272 +/- 21.9 micromol leucine/kg/h on d 0, 225 +/- 21.5 micromol leucine/kg/h on d 2, 231 +/- 21 micromol leucine/kg/h on d 4, and 242 +/- 17.6 micromol leucine/kg/h on d 7). Weight gain rates were significantly lower during the first week of dexamethasone treatment compared with the week before treatment or the second and third week. We conclude that during insulin and corticosteroid administration in very-low-birth-weight infants, no changes were observed in leucine kinetics in contrast to previous studies. The decrease in weight gain was not reversed.

Fibre optic versus conventional phototherapy for hyperbilirubinaemia in preterm infants.

UNLABELLED: Studies comparing efficacy of fibre optic phototherapy to conventional phototherapy are performed mostly in term infants and give conflicting results. This randomized prospective study compares efficacy of fibre optic phototherapy using the Ohmeda Biliblanket device to conventional fluorescent phototherapy in preterm infants. A total of 124 preterm infants with a nonhaemolytic hyperbilirubinaemia were evaluated. Stratification at randomisation was performed according to birth weight ( < 1000 g, 1000-1500 g or 1500-2000 g). Fifty-six infants received fibre optic and 68 conventional phototherapy. Efficacy was assessed by comparing the required duration of phototherapy. Median duration of phototherapy was 118 h and 114 h in the fibre optic and conventional groups respectively, the difference in which was not statistically significant. The median durations were also not significantly different within the separate weight groups. The number of infants requiring exchange transfusions was similar in both treatment groups. CONCLUSION: The efficacy of fibre optic phototherapy in preterm infants is comparable to conventional phototherapy.