Document Detail

Clinical measures to preserve cerebral integrity in preterm infants.
MedLine Citation:
PMID:  15814205     Owner:  NLM     Status:  MEDLINE    
Impaired psychomotor development, often anteceded by major intraventricular hemorrhage or periventricular leukomalacia, constitutes the most important long-term morbidity of very preterm infants. We reviewed randomized controlled trials aimed at reducing the incidence of brain damage, as detected by ultrasound, or neurodevelopmental impairment during follow-up of preterm infants. Preliminary reports of reduced rates of intraventricular hemorrhage obtained with administration of fresh frozen plasma, ethamsylate, phenobarbitone, or morphine have not been confirmed in subsequent larger trials. Early administration of indomethacin may reduce intraventricular hemorrhage without affecting long-term outcome. Pancuronium, inositol, and vitamin E decreased intraventricular hemorrhage rates but later psychomotor development was not examined. Thyroxin supplementation failed to improve neurodevelopmental outcome while protein enrichment of formula and individualized developmental care appear to be beneficial. The largest reductions in cerebral palsy and neurodevelopmental impairment were achieved by avoidance of postnatal steroids. This finding emphasizes the need to include these late endpoints in any randomized trial involving preterm infants.
Ursula Felderhoff-Mueser; Christoph Bührer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Early human development     Volume:  81     ISSN:  0378-3782     ISO Abbreviation:  Early Hum. Dev.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-04-07     Completed Date:  2005-05-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  237-44     Citation Subset:  IM    
Department of Neonatology, Charité Campus Virchow-Klinikum, Berlin, Germany.
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MeSH Terms
Brain Injuries / pathology,  prevention & control*
Cerebral Palsy / pathology,  prevention & control*
Guidelines as Topic
Infant, Newborn
Infant, Premature / physiology*
Infant, Very Low Birth Weight / physiology
Intensive Care, Neonatal / methods
Intracranial Hemorrhages / pathology,  prevention & control*

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