Publications by authors named "Corinne L Leach"
Inhaled nitric oxide (iNO) is approved for use in persistent pulmonary hypertension of the newborn (PPHN) but does not lead to sustained improvement in oxygenation in one-third of patients with PPHN. Inhaled NO is less effective in the management of PPHN secondary to congenital diaphragmatic hernia (CDH), extreme prematurity, and bronchopulmonary dysplasia (BPD). Intravenous pulmonary vasodilators such as prostacyclin, alprostadil, sildenafil, and milrinone have been successfully used in PPHN resistant to iNO.
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- Low cortisol levels in premature infants are linked to more severe illnesses and higher mortality rates, prompting a study on hydrocortisone treatment to prevent complications like bronchopulmonary dysplasia.
- Out of 291 survivors assessed at 18 to 22 months, hydrocortisone treatment led to improved awareness and fewer instances of low Mental Developmental Index scores, although overall neurodevelopmental impairment rates were similar to the placebo group.
- While some physical growth differences were noted in chorioamnionitis-exposed infants, hydrocortisone treatment did not increase the risk of cerebral palsy, indicating potential long-term developmental benefits.
Context: Various cosyntropin doses are used to test adrenal function in premature infants, without consensus on appropriate dose or adequate response.
Objective: The objective of this study was to test the cortisol response of extremely low birth weight infants to different cosyntropin doses and evaluate whether these doses differentiate between groups of infants with clinical conditions previously associated with differential response to cosyntropin.
Design: The design was a prospective, nested study conducted within a randomized clinical trial of low-dose hydrocortisone from November 1, 2001, to April 30, 2003.
Background: Infants developing bronchopulmonary dysplasia (BPD) show decreased cortisol response to adrenocorticotropic hormone. A pilot study of low-dose hydrocortisone therapy for prophylaxis of early adrenal insufficiency showed improved survival without BPD at 36 weeks' postmenstrual age, particularly in infants exposed to histologic chorioamnionitis.
Methods: Mechanically ventilated infants with birth weights of 500 to 999 g were enrolled into this multicenter, randomized, masked trial between 12 and 48 hours of life.