Randomized Placebo-controlled Trial of a 42-Day Tapering Course of Dexamethasone to Reduce the Duration of Ventilator Dependency in Very Low Birth Weight Infants: Outcome of Study Participants at  1-Year Adjusted Age

OʼShea, T. Michael; Kothadia, J. M.; Klinepeter, Kurt L; Goldstein, Donald J.; Jackson, Barbara G.; Weaver, Richard G.; Dillard, Robert G.

doi:10.1542/peds.104.1.15

Cited by 362 publications

(184 citation statements)

References 30 publications

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“…More recently, postnatal dexamethasone exposure has been correlated with the development of cerebral palsy. [21][22][23][24][25] In this study, infants with AN and SNHL were more likely to be exposed to dexamethasone than controls; however, this was not independent of the diagnosis of CLD.…”

Section: Discussionmentioning

confidence: 99%

Extremely low birth weight infants are at high risk for auditory neuropathy

et al. 2007

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Auditory neuropathy (AN) is a condition in which transmission of sound to the brain is abnormal. This is reflected as an electrophysiologic profile of normal otoacoustic emissions (OAE), with abnormal auditory brainstem evoked responses (ABR). Functionally speech perception is impaired and management strategies remain controversial. AN can be missed if high-risk newborns are screened for hearing loss with only OAE testing. The rate of sensorineural hearing loss (SNHL) in high-risk nursery infants is 10 times greater compared with normal term newborns. Therefore, we hypothesize that infants from the neonatal intensive care unit (NICU) are at significantly higher risk for AN than normal term infants.Objective: The objective of this study is to establish a prevalence rate and characterize risk factors for NICU graduates who demonstrate the AN electrophysiologic profile.Study Design: This retrospective study examined infants admitted to the NICU at Kapi'olani Medical Center for Women and Children in Honolulu, HI from 1999 through 2003. Infants were screened with automated ABR. Diagnostic testing and OAE were performed before discharge if the ABR was abnormal. Hospital courses of 24 AN, 71 SNHL and 95 gestational age (GA)-matched control infants with normal hearing were reviewed.Result: With a SNHL prevalence of 16.7/1000, the rate for AN was 5.6/1000 NICU infants. Compared to infants with SNHL, infants with AN were significantly younger (GA 28.3±4.8 AN vs 32.9±5.2 weeks SNHL, P<0.0001) and smaller (BW 1318±894 AN vs 1968±1006 g SNHL).Nearly two-thirds of the AN infants were ELBW and had significantly longer hospital stays compared to SNHL infants of the same birth weight group. Exposure to furosemide, aminoglycosides, vancomycin or dexamethasone was associated with increased AN but not SNHL. Peak bilirubin level correlated with SNHL but not AN.Conclusion: Low birth weight NICU infants are at significant risk for AN. ELBW infants are at significantly higher risk for both AN and SNHL.Infants admitted to the NICU should be routinely screened by automated ABR and if abnormal, further evaluation should be started before hospital discharge. Early identification of AN will result in better understanding of this disorder and lead to the development of appropriate intervention strategies.

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Section: Discussionmentioning

confidence: 99%

Extremely low birth weight infants are at high risk for auditory neuropathy

et al. 2007

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“…21,22 At the time of our study, there were no clinical studies suggesting this possible link, and the use of intravenous steroids was fairly common. Our study was not designed to evaluate long-term outcome.…”

Section: Discussionmentioning

confidence: 86%

A Randomized Trial of Inhaled Versus Intravenous Steroids in Ventilator-Dependent Preterm Infants

Suchomski

Cummings

2002

J Perinatol

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“…Investigators who had trained in epidemiology and the statistical sciences, who were not necessarily neonatologists contributed to the planning and implementation of long-term outcome studies. [24][25][26][27] This period was also characterized by the recognition of the importance of randomized clinical trials of perinatal care and of including health and neurodevelopment as an important outcome measure of such trials. 28 Collaborative multicenter research studies became popular as it was recognized that a large population with credible statistical power could be more rapidly and efficiently undertaken in this way.…”

Section: Historical Overviewmentioning

confidence: 99%

Neonatology fellowship training in research pertaining to development and follow-up

Hack

2006

J Perinatol

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The methodology of the study of the short-and long-term outcomes has changed over the 30-40 years since the indroduction of neonatal intensive care. The training of neonatal fellows in research pertaining to development and follow-up currently needs to include study of epidemiology and biostatistics, knowledge concerning normal and abnormal growth and development throughout the life span and clinical skills and/or knowledge concerning the assessment of neurologic and developmental outcomes.

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Randomized Placebo-controlled Trial of a 42-Day Tapering Course of Dexamethasone to Reduce the Duration of Ventilator Dependency in Very Low Birth Weight Infants: Outcome of Study Participants at 1-Year Adjusted Age

Cited by 362 publications

References 30 publications

Extremely low birth weight infants are at high risk for auditory neuropathy

Extremely low birth weight infants are at high risk for auditory neuropathy

A Randomized Trial of Inhaled Versus Intravenous Steroids in Ventilator-Dependent Preterm Infants

Neonatology fellowship training in research pertaining to development and follow-up

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