Effects of dexamethasone on blood pressure in premature infants with bronchopulmonary dysplasia☆,☆☆,★
Section snippets
METHODS
Babies with a clinical diagnosis of BPD were eligible for inclusion in the study if they were treated with dexamethasone to improve pulmonary mechanics. The decision to institute steroid therapy was made by the clinical team (attending neonatologist, neonatal fellow, pediatric residents, and neonatal nurse practitioners) caring for the infant. All infants in the study were ventilator and oxygen dependent at initiation of dexamethasone and had a chest radiograph consistent with the diagnosis of
RESULTS
In the 25-month period from Jan. 1, 1991, to Feb. 3, 1993, a total of 20 neonates with ventilator-dependent chronic lung disease were treated with dexamethasone. Three of the families of these 20 eligible babies declined participation in the study. One other infant was excluded from the analysis after his early death on the fourth day of steroid therapy.
The characteristics of the 16 study infants are presented in Table I.
Birthweight (gm) (mean ± SD) 715
DISCUSSION
There is general agreement that blood pressure increases as a function of weight and age in preterm infants.23, 24, 25, 26, 27 This study confirms this finding and, in addition, demonstrates a significant independent effect of dexamethasone on both SBP and DBP in this population of very low birth weight babies. Ours is the first such study of dexamethasone to adjust for the effects of postconceptional age and weight on blood pressure.
The prospective measurements of blood pressure allowed
Acknowledgements
We thank Majid Rasoulpour, MD, for his thoughtful review of the manuscript and the neonatal nurse practitioners and the nursing staff of the neonatal intensive care unit for their patience and assistance in collecting the blood pressure data.
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Cited by (35)
Neonatal Hypertension
2022, Clinics in PerinatologyCitation Excerpt :In one study of 500 consecutive infants treated with ECMO there was hypertension in 38%.2,38–40 Commonly used medications resulting in hypertension are dexamethasone, theophylline, phenylephrine eye drops, and pancuronium.41,42 Elevation in blood pressure may also occur during withdrawal from sedative or analgesic medications or in neonatal abstinence syndrome.2,43,44
The hypertensive neonate
2020, Seminars in Fetal and Neonatal MedicineCitation Excerpt :Not to be overlooked in the NICU is hypertension related to various medications. Dexamethasone [45], theophylline, phenylephrine ophthalmic drops [46], and pancuronium have all been implicated as causes of hypertension in neonates. Medication-induced hypertension is often dose-dependent and resolves with dose-reduction or withdrawal of the offending agent.
Systemic hypertension requiring treatment in the neonatal intensive care unit
2013, Journal of PediatricsCitation Excerpt :Similar to numerous other studies, we found a nearly 5-fold increase in the odds of infantile hypertension associated with BPD secondary to prematurity.4,6,9,15,18 Whether the hypertension with BPD is due to chronic hypoxemia and lung disease,4 hypercapnia,29 pulmonary hypertension,30 steroid use,13,31 or changes in the neurohormonal regulation of catecholamines, angiotensin, or antidiuretic hormone remains unknown. Our study supports the previous findings with a 3.8-fold increase in the adjusted odds of treated infantile hypertension with a PDA.6,9
Definition of Normal Blood Pressure Range: The Elusive Target
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2001, Obstetrics and Gynecology
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From the Divisions of Research and Neonatology and the Neonatal Intensive Care Unit, Connecticut Children's Medical Center, and the Department of Pediatrics, University of Connecticut School of Medicine, Hartford, Connecticut.
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Reprint requests: Kathleen A. Marinelli, MD, Connecticut Children's Medical Center, Division of Neonatology, 282 Washington St., Hartford, CT 06106.
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0022-3476/97/$5.00+0 9/21/78304