Related Experiment Videos
Inositol supplementation in respiratory distress syndrome
M Hallman1, M Pohjavuori, K Bry
1Children's Hospital, University of Helsinki, Finland.
Insights
Inositol supplementation in preterm infants may reduce respiratory issues and blindness. This nutrient is crucial for very low birth weight infants during critical neonatal transitions.
Area of Science:
- Neonatal Medicine
- Nutritional Science
- Pediatric Critical Care
Background:
- Inositol (INO) is a vital nutrient for immature preterm infants.
- Critically ill very low birth weight infants often lack INO in their nutrition.
- Preliminary studies suggest INO's importance for infant development.
Purpose of the Study:
- To investigate the effects of inositol supplementation on preterm infants with respiratory distress syndrome (RDS).
- To evaluate INO's impact on respiratory course, bronchopulmonary dysplasia (BPD), and retinopathy in very low birth weight infants.
Main Methods:
- A randomized, double-blind trial involving 230 preterm infants (gestation 24-31 weeks).
- Infants received either inositol (INO) or glucose (70-100 mg/kg/day) for 5 neonatal days, with potential additional courses.
- Supplementation continued if infants remained respirator-dependent and intolerant to breast milk.
Main Results:
- INO-supplemented infants showed a trend towards a milder respiratory course in the first week.
- Significantly lower incidence of bronchopulmonary dysplasia (BPD) in surviving INO-treated infants (p < 0.01).
- No INO-treated infant developed severe retinopathy (grade 4), compared to 8.8% blindness in placebo survivors (p < 0.005).
Conclusions:
- Inositol supplementation appears beneficial for very low birth weight infants with RDS.
- INO may reduce the incidence of BPD and severe retinopathy, improving outcomes.
- Inositol's antioxidant properties and role in cell growth warrant its consideration as a critical nutrient for vulnerable neonates.
Abstract:
According to preliminary results inositol (INO) is an important nutrient to immature preterm infants (J Pediatr 1987; 110:604). However, it is absent in nutrition of critically ill very low birth weight infants. In a present randomized double blind trial INO or glucose (70-100 mg/kg/day) was given to altogether 230 preterm infants (gestation 24 to 31 w, mean 27.8 w, mean BW 1,106 g) with RDS during 5 neonatal days. Two more courses during the first month were given, if the infant remained respirator-dependent and did not tolerate breast milk. INO-supplemented infants tended to have a milder respiratory course during the first week than those on glucose. The surviving INO-treated infants had a lower incidence of bronchopulmonary dysplasia (BPD) than the controls (p less than 0.01). No infant receiving INO had severe retinopathy (gr 4), whereas of the surviving placebo treated infants 8.8% became blind (p less than 0.005). Inositol promotes endothelial cell growth, enhances glucocorticoid-mediated lung epithelial cell differentiation, and may serve as an antioxidant. INO should be seriously considered as a nutrient during compromised neonatal transition of very low birth weight infants.