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MYOINOSITOL SUPPLEMENTATION REDUCES SEVERE COMPLICATIONS OF THE RESPIRATORY DISTRESS SYNDROME (RDS)

Breast milk is among the richest dietary sources of myoinositol (INO). Little if any INO is present in intravenous fluids given to sick preterm infants. Since INO promotes hormone-induced lung maturation in animals (Biochim Biophys Acta 795:67,1984), effects of INO supplementation (quantity similar to that present in breast milk) in RDS was studied. Sixty preterm infants received double-blind either 150 mg/kg/day of INO or identical quantity of glucose in isotonic solution during ten neonatal days. All infants weighed < 2000 g and required mechanical ventilation for at least two neonatal days to treat RDS.INO supplementation increased the already high levels of serum INO present at birth in RDS, whereas serum INO tended to decrease among controls who received little breast milk. There was no difference in birth weight (1334±289g), gestational age (29.8±2.1 w), or severity of RDS at birth among the two groups. However, RDS was less severe in INC group during days 5 to 9. Four INO-infants and 8 controls had bronchopulmonary dysplasia (BPD). Two INO-infants and 7 controls died. The incidence of death and/or BPD was higher in controls than in INO-group (p=0.04). There was no detectable difference in the incidence of intraventricular hemorrage, patent ductus arteriosus, necrotizing enterocolitis, or infections. The long-term follow-up continues.According to present results INO supplementation to small preterm infants favorably modifies the course of RDS. INO may accelerate the neonatal development of the lung, and potentiate the effect of glucocorticoid on the lung.