Early low-dose hydrocortisone in very preterm infants: a randomized, placebo-controlled trial.
Neonatology
; 91(4): 217-21, 2007.
Article
in En
| MEDLINE
| ID: mdl-17568152
ABSTRACT
BACKGROUND:
Several reports indicate a decreased cortisol response to adrenocorticotropic hormone in preterm infants developing chronic lung disease and in preterm infants with refractory hypotension. Low-dose hydrocortisone (HC) may allow for beneficial effects.OBJECTIVE:
Our aim was to assess whether HC is able to increase survival without chronic lung disease.METHODS:
We performed a double-blind, randomized, placebo-controlled trial. Fifty mechanically ventilated infants (birth weight 500-1,249 g) were randomized to receive treatment (HC 0.5 mg/kg/12 h for 9 days, then HC 0.5 mg/kg/24 h for 3 days) or placebo. Major outcome was survival without oxygen dependence at 36 weeks of postconceptional age (O(2)-free survival).RESULTS:
The basic characteristics were similar between the two groups. O(2)-free survival was higher in the HC group (64 vs. 32%). The advantage was particularly evident among infants without antenatal steroids. The mortality rate was 16% in the HC group versus 40% in the control group (difference not significant). Hypotension after recruitment was reduced by HC (0 vs. 30%). The incidence of gastrointestinal perforation and other adverse effects was similar between the two groups.CONCLUSIONS:
HC prophylaxis improved O(2)-free survival and early cardiocirculatory function in our population, without important short-term effects. The neurodevelopmental outcome will be assessed at 2 years.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Infant, Premature
/
Hydrocortisone
Type of study:
Clinical_trials
Limits:
Female
/
Humans
/
Male
/
Newborn
Language:
En
Journal:
Neonatology
Journal subject:
PERINATOLOGIA
Year:
2007
Document type:
Article
Affiliation country: