Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 55 (2), 360-368

Respiratory Medication Use in Extremely Premature ( <29 Weeks) Infants During Initial NICU Hospitalization: Results From the Prematurity and Respiratory Outcomes Program

Affiliations

Respiratory Medication Use in Extremely Premature ( <29 Weeks) Infants During Initial NICU Hospitalization: Results From the Prematurity and Respiratory Outcomes Program

James M Greenberg et al. Pediatr Pulmonol.

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.

Keywords: bronchopulmonary dysplasia; neonatal chronic lung disease; practice variation.

Similar articles

See all similar articles

References

REFERENCES

    1. O'Donnell CP, Stone RJ, Morley CJ. Unlicensed and off-label drug use in an Australian neonatal intensive care unit. Pediatrics. 2002;110(5). e52
    1. Stenger MR, Slaughter JL, Kelleher K, et al. Hospital variation in nitric oxide use for premature infants. Pediatrics. 2012;129(4):e945-e951.
    1. Cheng CL, Yang YH, Lin SJ, Lin CH, Lin YJ. Compliance with dosing recommendations from common references in prescribing antibiotics for preterm neonates. Pharmacoepidemiol Drug Saf. 2010;19(1):51-58.
    1. Burgess KS, Philips S, Benson EA, et al. Age-related changes in MicroRNA expression and pharmacogenes in human liver. Clin Pharmacol Ther. 2015;98(2):205-215.
    1. Toro-Ramos T, Paley C, Pi-Sunyer FX, Gallagher D. Body composition during fetal development and infancy through the age of 5 years. Eur J Clin Nutr. 2015;69(12):1279-1289.

LinkOut - more resources

Feedback