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Respiratory medication use in extremely premature (<29 weeks) infants during initial NICU hospitalization: Results from the prematurity and respiratory outcomes program.
Greenberg, James M; Poindexter, Brenda B; Shaw, Pamela A; Bellamy, Scarlett L; Keller, Roberta L; Moore, Paul E; McPherson, Christopher; Ryan, Rita M.
  • Greenberg JM; Departments of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
  • Poindexter BB; Departments of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
  • Shaw PA; Department of Biostatistics, Epidemiology and Informatics, Perlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
  • Bellamy SL; Department of Biostatistics, Epidemiology and Informatics, Perlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
  • Keller RL; Department of Pediatrics, University of California-San Francisco, San Francisco, California.
  • Moore PE; Departments of Pediatrics and Pharmacology, Vanderbilt University, Nashville, Tennessee.
  • McPherson C; Department of Pediatrics, Washington University, St. Louis, Missouri.
  • Ryan RM; Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina.
Pediatr Pulmonol ; 55(2): 360-368, 2020 02.
Article in English | MEDLINE | ID: covidwho-1064413
Semantic information from SemMedBD (by NLM)
1. Respiratory medication NOS TREATS Bronchopulmonary Dysplasia
Subject
Respiratory medication NOS
Predicate
TREATS
Object
Bronchopulmonary Dysplasia
2. Diuretics TREATS Bronchopulmonary Dysplasia
Subject
Diuretics
Predicate
TREATS
Object
Bronchopulmonary Dysplasia
3. Steroids TREATS Bronchopulmonary Dysplasia
Subject
Steroids
Predicate
TREATS
Object
Bronchopulmonary Dysplasia
4. Pharmaceutical Preparations CAUSES Adverse effects
Subject
Pharmaceutical Preparations
Predicate
CAUSES
Object
Adverse effects
5. Respiratory medication NOS TREATS Bronchopulmonary Dysplasia
Subject
Respiratory medication NOS
Predicate
TREATS
Object
Bronchopulmonary Dysplasia
6. Diuretics TREATS Bronchopulmonary Dysplasia
Subject
Diuretics
Predicate
TREATS
Object
Bronchopulmonary Dysplasia
7. Steroids TREATS Bronchopulmonary Dysplasia
Subject
Steroids
Predicate
TREATS
Object
Bronchopulmonary Dysplasia
8. Pharmaceutical Preparations CAUSES Adverse effects
Subject
Pharmaceutical Preparations
Predicate
CAUSES
Object
Adverse effects
ABSTRACT

BACKGROUND:

The use of medications to treat respiratory conditions of extreme prematurity is often based upon studies of adults or children over 2 years of age. Little is known about the spectrum of medications used or dosing ranges. To inform the design of future studies, we conducted a prospective analysis of respiratory medication exposure among 832 extremely low gestational age neonates.

METHODS:

The prematurity and respiratory outcomes program (PROP) enrolled neonates less than 29-week gestation from 6 centers incorporating 13 clinical sites. We collected recorded daily "respiratory" medications given along with dosing information through 40-week postmenstrual age or neonatal intensive care unit discharge if earlier.

RESULTS:

PROP participants were exposed to a wide range of respiratory medications, often at doses beyond published recommendations. Nearly 50% received caffeine and furosemide beyond published recommendations for cumulative dose. Those who developed bronchopulmonary dysplasia were more likely to receive treatment with respiratory medications. However, more than 30% of PROP subjects that did not develop bronchopulmonary dysplasia also were treated with diuretics, systemic steroids, and other respiratory medications.

CONCLUSION:

Extremely preterm neonates in PROP were exposed to high doses of medications at levels known to generate significant adverse effects. With limited evidence for efficacy, there is an urgent need for controlled trials in this vulnerable patient population.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Infant, Premature / Intensive Care Units, Neonatal Type of study: Clinical Practice Guide / Observational study Limits: Child / Child, preschool / Female / Humans / Infant / Male / Infant, Newborn Language: English Journal: Pediatr Pulmonol Journal subject: Pediatrics Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Infant, Premature / Intensive Care Units, Neonatal Type of study: Clinical Practice Guide / Observational study Limits: Child / Child, preschool / Female / Humans / Infant / Male / Infant, Newborn Language: English Journal: Pediatr Pulmonol Journal subject: Pediatrics Year: 2020 Document Type: Article