Off-Label Drugs in Neonatology: Analyses Using Large Data Bases
Two reports in this volume of The Journal from the neonatology team at the University of North Carolina use the Pediatrix Medical Group Data Warehouse of administrative information to further the ongoing discussion of the frequent off-label uses of drugs in the neonatal intensive care unit (NICU).1,2 The report on the frequent, but not approved, use of furosemide for bronchopulmonary dysplasia (BPD) identified that prolonged use can decrease BPD.1 The report on surfactant for preterm infants with or at risk of respiratory distress syndrome (RDS) identified frequent deviations from the Food and Drug Administration (FDA) approved uses.
Abstract Adult survivors of very preterm (≤32 weeks gestational age)birth without (PRE) and with bronchopulmonary dysplasia (BPD) have variable degrees of airflow obstruction at rest. Assessment of the shape of the maximal expiratory flow-volume (MEFV) curve in PRE and BPD may provide information concerning their unique pattern of airflow obstruction. The purposes of the present study were to: i) quantitatively assess the shape of the MEFV curve in PRE, BPD, and healthy adults born at full-term (CON), ii) identify where along the MEFV curve differences in shape existed between groups, and iii) determine the ass...
CONCLUSIONS: Our study suggests that neonatal C57 mtDNA carrying strains have increased hyperoxia-induced hypoalveolarization, pulmonary mechanical dysfunction and mitochondrial bioenergetic and redox dysfunction vs. C3H mtDNA strains. Therefore, mtDNA haplogroup variation-induced differences in mitochondrial function could modify neonatal alveolar development and BPD susceptibility. PMID: 31432715 [PubMed - as supplied by publisher]
Condition: Bronchopulmonary Dysplasia Intervention: Combination Product: stem cell transplantation Sponsor: Vinmec Research Institute of Stem Cell and Gene Technology Recruiting
Journal of Perinatology, Published online: 20 August 2019; doi:10.1038/s41372-019-0458-yReply to: Transpyloric feeds and bronchopulmonary dysplasia
CONCLUSIONS In hyperoxia-induced rat models of BPD, hBD2 promotes alveolarization and improves pulmonary function. The mechanism may contribute in alleviating inflammation response and inhibiting pro-inflammatory factors including IL-1ß, IL-6, and TNF-alpha. PMID: 31411185 [PubMed - in process]
Journal of Perinatology, Published online: 14 August 2019; doi:10.1038/s41372-019-0465-zTranspyloric feeds and bronchopulmonary dysplasia
AbstractBackgroundBronchopulmonary dysplasia (BPD) is the need for oxygen therapy at 36 weeks postmenstrual age (PMA). Sildenafil has been shown to enhance the lung alveolarization and vascularization in newborn animal models after lung injury and has possible therapeutic potential for the prevention of BPD.ObjectiveTo perform a proof-of-concept, Phase II, pilot randomized, double-blind, clinical trial to study the efficacy of sildenafil in preventing BPD, in postnatal (
Abstract Hyperoxia exposure in premature infants increases the risk of subsequent lung diseases such as asthma and bronchopulmonary dysplasia. Fibroblasts help maintain bronchial and alveolar integrity. Thus understanding mechanisms by which hyperoxia influences fibroblasts is critical. Cellular senescence is increasingly recognized as important to pathophysiology of multiple diseases. We hypothesized that clinically-relevant moderate hyperoxia (