Effect of early caffeine treatment on the need for respirator therapy in preterm infants with respiratory distress syndrome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the efficacy of early caffeine treatment in preterm infants with respiratory distress syndrome (RDS).</p><p><b>METHODS</b>A prospective controlled clinical trial was performed. A total of 59 preterm infants with RDS were enrolled and divided into a caffeine group (30 infants) and a control group (29 infants). Caffeine was administered in the caffeine group and control group at the same dosage at 12-24 hours after birth and before extubation respectively. The respirator parameters and the incidence rates of ventilator-associated pneumonia (VAP) and apnea were compared between the two groups.</p><p><b>RESULTS</b>Compared with the control group, the caffeine group had significantly lower peak inspiratory pressure, peak fraction of inspired oxygen, and incidence rate of VAP (p<0.05), as well as significantly shorter intubation time, NCPAP time, and total duration of oxygen supply (p<0.05). In addition, the caffeine group had a significantly longer time to first onset of apnea after extubation (p<0.05) and significantly fewer times of onset of apnea 1-2 days after extubation (p<0.01), as compared with the control group.</p><p><b>CONCLUSIONS</b>Early caffeine treatment can reduce the need for assisted ventilation in preterm infants with RDS, help with early extubation and ventilator weaning, reduce the oxygen time in the late stage, reduce the incidence of VAP, and prevent the development of apnea after extubation.</p>

Changes of Serum Level of Leptin,Growth Hormone,Insulin Like Growth Factor-1 and Insulin Like Growth Factor Binding Protein-3 in Different Intrauterine Growth and Development Situation / 实用儿科临床杂志

Objective To explore the relationship between the serum level of leptin,growth hormone(GH),insulin like growth factor-1(IGF-1),insulin like growth factor binding protein-3(IGFBP-3)and those modulatine effects on fetal growth.Methods One hundred and thirty-five cases of newborns were divided into 4 groups according to the relationship between born weight and gestational age.Group A:premature infants small for gestational age(SGA),n=30.Group B:premature infants appropriate for gestational age(AGA),n=36.Group C:mature infants small for gestational age,n=32.Group D:mature infants appropriate for gestational age,n=37.All infants were measured se-rum leptin,GH,IGF-1 and IGFBP-3 level with radiommunosassay(RIA).Results There were significant difference in the levels of leptin,GH,IGF-1,IGFBP-3 as group C0.05).There were positive correlation between levels of leptin,IGF-1 and IGFBP-3 in group A,B and C,while,there was positive correlation between only level of IGF-1 in group D.Conclusions Leptin,IGF-1 and IGFBP-3 may play an important role in the fetal growth regulation of premature infants and IUGR infants.IGF-1 also regulate intrauterine growth of group D.Another side,in group D,Leptin,GH,IGF-1 and IGFBP-3 don't regulate fetal growth.