A survey and audit of postnatal corticosteroid use to reduce the risk of chronic lung disease in extremely preterm infants
- Research Opportunity
- Number of Honour Places Available
- Obstetrics and Gynaecology
|Dr Brett Manleyemail@example.com||0383453766|
|Professor Peter Davisfirstname.lastname@example.org||0383453763|
|Dr Omar Kamlinemail@example.com||0383453769|
Summary A survey and multicentre audit of systemic corticosteroid use to reduce the risk of chronic lung disease in extremely preterm infants.
Extremely preterm infants born before 28 weeks gestation (more than 3 months early) usually have significant breathing difficulties and all require neonatal intensive care. They require breathing support from soon after birth to treat respiratory distress syndrome, and many need supplemental oxygen treatment. The sickest infants require mechanical ventilation, sometimes for many weeks.
About half of extremely preterm infants go on to develop bronchopulmonary dysplasia (BPD), the chronic lung disease of prematurity. Whilst the pathophysiology of BPD is complex, inflammation is a major contributor. Therefore, anti-inflammatory drugs such as systemic corticosteroids (CS) can be used to reduce inflammation in an attempt to wean infants from mechanical ventilation. Whilst CS are very effective, if used early and routinely in extremely preterm infants they have side-effects including adverse long-term effects such as increasing the risk of cerebral palsy. They also have short-term side-effects including hyperglycaemia, hypertension and increased risk of sepsis. Therefore, systemic CS are used judiciously, in only the sickest infants.
Neonatal specialists prescribe systemic CS based on clinical protocols that have been widely used. The aim is to limit both the dose and duration of CS to decrease the risk of adverse effects. However, despite good intentions, many of the sicker infants ultimately receive higher doses or longer courses than planned. The doses and durations of systemic CS received by extremely preterm infants are not widely reported.
In this study, we plan to: 1) survey Australian neonatal intensive care units to determine local protocols for the initiation, type, dose and duration of systemic CS treatment to reduce the risk of BPD in extremely preterm infants; and 2) perform a multicentre audit of type, doses, durations and side-effects of systemic CS received by extremely preterm infants.
In addition to the study activities, the student will be exposed to the daily activities of a busy tertiary neonatal intensive care unit in a large maternity hospital, and the varied research being undertaken there.
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