Background-Intramuscular supplementation with vitamin A in large doses may reduce the incidence of chronic lung disease. Aim-To investigate whether oral supplementation with vitamin A would reduce the incidence of chronic lung disease in a group of extremely low birthweight infants. Methods-Infants with birth weight < 1000 g were randomised at birth to receive oral vitamin A supplementation (5000 IU/day) or placebo for 28 days. The primary outcome was oxygen dependency at 28 days of age or death. Results-A total of 154 infants were randomised; 77 received vitamin A (median birth weight (interquartile range) 806 (710-890) g), and 77 received placebo (median birth weight (interquartile range) 782 (662-880) g). Plasma vitamin A concentrations in the supplemented group were significantly higher at 24 hours of age but did not diVer significantly at birth, 12 hours of age, 7 days, or 28 days of life. There were no significant diVerences in the proportion of infants who survived, required oxygen at 28 days, required oxygen at 36 weeks postmenstrual age, survived without chronic lung disease at 36 weeks, survived without significant retinopathy, or who survived without significant intraventricular haemorrhage. Conclusions-Oral supplementation with 5000 IU vitamin A in extremely low birthweight infants does not significantly alter the incidence of chronic lung disease. However, this dose may have been inadequate to achieve optimal serum retinol concentrations. (Arch Dis Child Fetal Neonatal Ed 2001;84:F9-F13) Keywords: chronic lung disease; lungs; preterm; vitamin A; retinol Preterm infants have limited hepatic reserves and lower plasma concentrations of vitamin A and plasma retinol binding protein than term infants because vitamin A is transferred across the placenta mainly during the third trimester.

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Conjunctival impression cytology is simple and reproducible technique which maybe easily applied to the preterm infant. Abnormal CIC is associated with retinopathy of prematurity requiring treatment.

This pilot study indicates that rhGH administered preoperatively has beneficial effects on skeletal muscle and respiratory function and may be more useful than postoperative rhGH administration alone.