Hypotension following patent ductus arteriosus ligation: the role of adrenal hormones.

Objective: To test the hypothesis that an impaired adrenal response to stress might play a role in the hypotension that follows patent ductus arteriosus (PDA) ligation.

Study Design: We performed a multicenter study of infants born at <32 weeks' gestation who were about to undergo PDA ligation. Serum adrenal steroids were measured 3 times: before and after a cosyntropin (1.

Enteral feeding during indomethacin and ibuprofen treatment of a patent ductus arteriosus.

Objective: To test the hypothesis that infants who are just being introduced to enteral feedings will advance to full enteral nutrition at a faster rate if they receive "trophic" (15 mL/kg/d) enteral feedings while receiving indomethacin or ibuprofen treatment for patent ductus arteriosus.

Study Design: Infants were eligible for the study if they were 23(1/7)-30(6/7) weeks' gestation, weighed 401-1250 g at birth, received maximum enteral volumes ≤60 mL/kg/d, and were about to be treated with indomethacin or ibuprofen. A standardized "feeding advance regimen" and guidelines for managing feeding intolerance were followed at each site (N = 13).

Administration of rescue surfactant by laryngeal mask airway: lessons from a pilot trial.

Objectives: To determine if surfactant can be effectively administered to larger preterm babies by laryngeal mask airway (LMA), reducing the need for supplemental oxygen.

Study Design: Enrollment criteria: birth weight > 1200 g, < 72 hours old, treated with nasal continuous positive airway pressure (nCPAP) for respiratory distress syndrome, with fraction of inspired oxygen (Fio2) requirement between 0.30 and 0.

Understanding clinical literature relevant to spontaneous intestinal perforations.

Spontaneous intestinal perforation (SIP) has emerged as a disease of extremely low-birth-weight (ELBW) infants over the last two decades. Several risk factors have been associated with this disease including early postnatal steroids (EPS; use within the first week of life), early use of indomethacin (EUI; use within the first 3 postnatal days), and the synergistic combination of the two. These two risk factors are thought to play a causal role in the etiology of SIP through their effects on ileal trophism and motility.