Physiological, hormonal and metabolic responses to a single midazolam dose in intubated and ventilated preterm neonates

Amaç

To determine the response of ventilated preterm neonates to a single dose of midazolam given before intubation.

Yöntem

In a prospeetive, randomized, placebo controlled trial 20 mechanicaliy ventilated preterm neonates (<36 weeks) were studied before medication and intubation and 60 minutes after administration of midazolam or placebo. Patients were eligible if they required intubation and ventilatory support within 12 hours after birth. Exclusion criteria included major congenital anomalies, perinatal asphyxia and receiving analgesics and sedatives. Physiological responses recorded during each period were heart rate, arterial blood gases, ventilator settings. As metabolic and hormonal parameters, blood glucose and serum cortisol levels were measured before and 60 minutes after administration of midazolam as metabolic and hormonal parameters.

Bulgular

 İn the study group, before intubation all patients had respiratory insufficiency measured in blood gases. İnfants characteristics, blood glucose and serum cortisol levels were similar for the neonates who randomly were given midazolam and placebo. All infants presented high basal levels of cortisol before any medication, which indicated the presence of stress (in the midazolam group: 793-51857.6, placebo group: 19%.9±2026.1 nmol/L). in the midazolam group, patients had significantly lower levels of senim cortisol after administration of midazolam compared to the basal levels (740.8±378.5vs 793.5+857.6 nmo 1/L). In the placebo group serum cortisol levels were higher than basal levels but the difference was not significant.
 
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