Although the risk of developing hypothalamic-pituitary-adrenal (HPA) suppression is very low with inhaled budesonide; formoterol, patients should, nevertheless, be monitored for this possibility. Particular care is needed for patients who are transferred from systemic to inhaled corticosteroids because deaths due to adrenal insufficiency have occurred in asthmatic patients during and after transfer from systemic to less systemically absorbed inhaled corticosteroids. Patients previously maintained on doses equivalent to greater than or = 20 mg/day of prednisone may be at increased risk. After withdrawal from systemic corticosteroids, a number of months are required for recovery of HPA-axis function.
I have done pretty much every job there can be in ophthalmology that isnt done by a surgeon, anesthesiologist/anesthetist, from visual acuity tests, refractions, tonometry both with a "pen" type and the one of the scope (I never used the puff of air type though) to work ups for cataracts, I also used to see the Day 1 post ops and checked implant placement and for corneal edema or any complications. I have scrubbed in for surgery, been a circulator, I have done Pre-op helping the anesthesiologist and the post op sending patients home. I have helped with cataract surgeries, glaucoma surgeries, corneal transplants, retinal surgeries of various kinds, RK and LASIK refractive surgeries as well, so I had a pretty well rounded tour as an ophthalmic nurse.
Results Of 1072 neonates screened, 523 were assigned to hydrocortisone (n = 256) or placebo (n = 267) and 406 survived to 2 years of age. A total of 379 patients (93%; 46% female) were evaluated (194 in the hydrocortisone group and 185 in the placebo group) at a median corrected age of 22 months (interquartile range, 21-23 months). The distribution of patients without neurodevelopmental impairment (73% in the hydrocortisone group vs 70% in the placebo group), with mild neurodevelopmental impairment (20% in the hydrocortisone group vs 18% in the placebo group), or with moderate to severe neurodevelopmental impairment (7% in the hydrocortisone group vs 11% in the placebo group) was not statistically significantly different between groups ( P = .33). The mean global developmental quotient score was not statistically significantly different between groups ( in the hydrocortisone group vs in the placebo group; between-group difference, [95% CI, − to ]; P = .83). The incidence of cerebral palsy or other major neurological impairments was not significantly different between groups.