Intraventricular hemorrhage and vitamin E in the very low-birth-weight infant: evidence for efficacy of early intramuscular vitamin E administration

To determine whether early intramuscular vitamin E supplementation influences the incidence of intraventricular hemorrhage (IVH) in infants with birth weight less than or equal to 1,500 g, data were analyzed from 134 infants enrolled on a protocol to evaluate the efficacy of intramuscular plus oral...

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Bibliographic Details
Published in:Pediatrics (Evanston) 1984-12, Vol.74 (6), p.1107-1112
Main Authors: Speer, M.E, Blifeld, C, Rudolph, A.J, Chadda, P, Holbein, M.E.B, Hittner, H.M
Format: Article
Language:English
Subjects:
Administration, Oral
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Cerebral Hemorrhage - prevention & control
Cerebral Ventricles
CIRCULATORY DISORDERS
Double-Blind Method
Drug Evaluation
Emergency and intensive care: neonates and children. Prematurity. Sudden death
Emulsions
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature, Diseases - prevention & control
INJECTION
Injections, Intramuscular
Intensive care medicine
INYECCION
MADUREZ PRECOZ
Medical sciences
PREMATURITE
PREMATURITY
Random Allocation
TOCOFEROLES
TOCOPHEROL
TOCOPHEROLS
TRASTORNOS CIRCULATORIOS
TROUBLE CIRCULATOIRE
VENTRICLES
Vitamin E - administration & dosage
Vitamin E - blood
Vitamin E - therapeutic use
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Summary:To determine whether early intramuscular vitamin E supplementation influences the incidence of intraventricular hemorrhage (IVH) in infants with birth weight less than or equal to 1,500 g, data were analyzed from 134 infants enrolled on a protocol to evaluate the efficacy of intramuscular plus oral vitamin E v oral supplementation alone in the treatment of retrolental fibroplasia. All 134 infants received, via nasogastric tube, 100 mg/kg/d of vitamin E daily (dl-alpha-tocopheryl acetate in MCT [medium-chain triglyceride] oil; 150 mosM) for at least 8 weeks with the first dose administered within the first eight hours of life. Sixty-four patients received, in addition, intramuscular vitamin E on days 1, 2, 4, and 6 of life and 70 patients received placebo injections in a randomized double-blind fashion. In the first week, vitamin E plasma levels were significantly higher in the 64 patients given intramuscular vitamin E. In spite of this difference no change in the incidence of sepsis or necrotizing enterocolitis was observed. Both the incidence and severity of intraventricular hemorrhage were reduced significantly in the patients given intramuscular vitamin E as compared to the patients given placebo (P = .013 and P = .04, respectively). The data suggest that vitamin E, a natural antioxidant, may play an important role in protecting the CNS microcirculation from the effects of hypoxic/ischemic injury.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.74.6.1107