DEXAMETHASONE STUDY

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. During year three of this project I moved my focus away from the animal model that initially drove this proposal to a clinical research focus. Several projects are ongoing, once near completion. Due to the use of shorter courses and lower doses of glucocorticoids in clinical practice, we altered the initial aims of the proposal to study the effects of exposure to a short course of either dexamethasone or hydrocortisone during the early neonatal period on development of the LHPA axis. We have completed analysis of behavioral and physiological studies of our dexamethasone vs. hydrocortisone study and are readying a manuscript for submission. Development of a clinical study to examine effects of chronic maternal stress on neurodevelopment is on hold while the group studying pregnancy and PTSD ready a proposal for submission. As a result I have moved my focus onto development of several clinical research studies. Each of these are in collaboration with the Clinical Research Center, and for each I am the principal investigator. These include 1) development of a multidisciplinary craniofacial clinic paralleling development of a study of health-related quality of life measures in clinic participants and parents, 2) development and implementation of a fetal and neonatal palliative care program with development of quality of life measures in program participants, 3) evaluation of generalized movements in preterm and term infants to study early prediction of cerebral palsy, 4) use of heliox with nasal CPAP in extremely low birth weight infants to prevent respiratory failure, 5) evaluation of implementation of a breast milk only practice (maternal and donor breast milk) on the incidence of necrotizing enterocolitis in a level III NICU and 6) comparison of sodium chloride versus sodium acetate in arterial catheter fluids in extremely premature infants to limit extent of metabolic acidosis.