Growth hormone does not prevent catabolic side effects of dexamethasone in extremely low birth weight preterm infants with bronchopulmonary dysplasia--a pilot study.
Recombinant human growth hormone (rhGH) may reduce the catabolic side effects of steroid therapies on children and adults, but this has never been studied in preterm infants. We performed a pilot study on 5 extremely low birth weight preterm infants (gestational age 27 +/- 3 wks, birth weight 824 +/- 160 g) still on mechanical ventilation for bronchopulmonary dysplasia at the postnatal age of 35 +/- 9 days. All were treated for 7 days with dexamethasone (0.5 mg/kg/d i.v.) and subcutaneous rhGH at different doses: 0.1 (n = 1), 0.2 (n = 2) or 0.3 (n = 2) IU/kg/day. Nutrition was kept stable. After 7 days all subjects improved their respiratory condition but body weight remained the same and urinary urea nitrogen and C-peptide were significantly higher (p < 0.001). rhGH intake strongly related to urinary excretion of urea nitrogen (r = 0.78) and C-peptide (r = 0.88). Dexamethasone improves the pulmonary function of very preterm infants with bronchopulmonary dysplasia but induces growth arrest and catabolism which are not prevented, and may be worsened, by rhGH.
Tonini
G
G
Divisione di Neonatologia e Terapia Intensiva Neonatale Istituto per l'Infanzia Burlo Garofolo, Trieste, Italy.
Pahor
T
T
Colonna
F
F
de Vonderweid
U
U
D000410:Alanine Transaminase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D001724:Birth Weight; D001806:Blood Urea Nitrogen; D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy*; D002096:C-Peptide / Q000652:urine; D002784:Cholesterol / Q000097:blood; D003907:Dexamethasone / Q000009:adverse effects* / Q000627:therapeutic use; D005865:Gestational Age; D006130:Growth Disorders / Q000139:chemically induced; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D009584:Nitrogen / Q000652:urine; D010865:Pilot Projects; D012121:Respiration, Artificial; D014508:Urea / Q000652:urine
D002096:C-Peptide; D019382:Human Growth Hormone; D003907:Dexamethasone; D014508:Urea; D002784:Cholesterol; D000410:Alanine Transaminase; D009584:Nitrogen; D001663:Bilirubin