Inositol supplementation in respiratory distress syndrome.

According to preliminary results inositol (INO) is an important nutrient to immature preterm infants (J Pediatr 1987; 110:604). However, it is absent in nutrition of critically ill very low birth weight infants. In a present randomized double blind trial INO or glucose (70-100 mg/kg/day) was given to altogether 230 preterm infants (gestation 24 to 31 w, mean 27.8 w, mean BW 1,106 g) with RDS during 5 neonatal days. Two more courses during the first month were given, if the infant remained respirator-dependent and did not tolerate breast milk. INO-supplemented infants tended to have a milder respiratory course during the first week than those on glucose. The surviving INO-treated infants had a lower incidence of bronchopulmonary dysplasia (BPD) than the controls (p less than 0.01). No infant receiving INO had severe retinopathy (gr 4), whereas of the surviving placebo treated infants 8.8% became blind (p less than 0.005). Inositol promotes endothelial cell growth, enhances glucocorticoid-mediated lung epithelial cell differentiation, and may serve as an antioxidant. INO should be seriously considered as a nutrient during compromised neonatal transition of very low birth weight infants.