Effects of Budesonide Inhalation on Energy Expenditure, Somatic Growth and Salivary Cortisol Levels in Preterm Infants with Chronic Lung Disease

Abstract

Background: We hypothesized that the use of inhaled budesonide (BUD) would alter somatic growth by increasing energy expenditure (EE) in premature infants with chronic lung disease (CLD). Methods: A prospective study was conducted of the effect of BUD on EE, growth and salivary cortisol excretion in infants with CLD who required supplemental oxygen and were treated with inhaled BUD for 4 weeks according the severity of their CLD, or without BUD treatment. Infants were compared with a healthy control group matched for gestational age. EE, anthropometric measures and salivary cortisol levels were examined before, during and after BUD treatment. Results: A total of 30 spontaneously breathing premature infants were enrolled in the study. EE in CLD (BUD) and CLD (no BUD) patients were greater than EE in healthy preterm infants (p < 0.01) at the study time points. Growth did not differ between the groups. Salivary cortisol levels of treated infants were significantly lower when compared with the levels of nontreated infants. Conclusion: The administration of inhaled BUD in preterm infants with CLD was associated with an increase in EE, a suppression of endogenous cortisol production and with no effect on duration of supplemental oxygen, but did not compromise their somatic growth.

Relationship of Salivary and Plasma Cortisol Levels in Preterm Infants: Results of a Prospective Observational Study and Systematic Review of the Literature

“…Saliva collection is easy to perform and reliable in adults and older children wherefore salivary concentrations of cortisol reflecting free cortisol concentrations in plasma is used to evaluate adrenal cortex function [4][5][6][7] . The best method of assessing adrenal function in preterm infants still is under debate but salivary cortisol measurement seems to be a promising diagnostic feature for these infants, too [8][9][10] .…”

Longitudinal Measurements of Resting Energy Expenditure by Indirect Calorimetry in Healthy Term Infants during the First 2 Months of Life

“…Many previously published studies conducted between 1990 and 2010 used the Deltatrac II indirect calorimeter. 11,18 To the best of our knowledge, this is the first study demonstrating longitudinal data of REE for healthy term infants at 1 and 2 months of age using a currently employed IC technology. ParvoMedics TrueOne 2400 IC provides highly accurate measurements of minute ventilation, VO 2 and VCO 2 as supported in previous publications by Crouter et al 22 and Cooper et al 23 Overall, we found a slight decrease in REE values from 1 to 2 months of age.…”

“…periods of time. [10][11][12][13] There are limited studies evaluating REE values immediately after birth [12][13][14][15][16] and sparse normative longitudinal REE data for healthy term infants at 1 and 2 months of age, which is a critical period of development.…”

“…3,17 The previous research that has been done with IC in infants has primarily focused on the premature population and critically ill term infants with limited control patient data. 11,12,[18][19][20] We conducted a pilot study in an outpatient office setting to determine longitudinal normative REE values with IC in healthy term newborns at 1 and 2 months of age.…”

Structure of triosephosphate isomerase fromCryptosporidium parvum

“…As of January 2011, 118 structures of TIM have been released in the PDB. The first apo structure of TIM from chicken muscle was deposited in 1976 (PDB entry 1tim; Banner et al, 1976). This was followed in 1990 by the deposition of the first ligand-bound structure of yeast TIM in the PDB [PDB entries 1ypi ) and 2ypi ].…”