Chronic lung disease of prematurity: are we too cautious with steroids?
Encompassed by the term chronic lung disease (CLD) of prematurity is a sequence of pathophysiological processes ranging from acute inflammation and its resolution to remodelling and growth. There is good evidence for clinical and biological effects of parenteral corticosteroid therapy at each stage in the disease process. A number of questions remain to be resolved: can risk prediction be refined to permit trials of prevention; what is the minimum effective dosage regime; are topical corticosteroids effective; what are the long-term effects on lung growth and development and indeed, is the long-term prognosis of CLD affected by corticosteroid therapy? It is prudent to be cautious with steroids until these questions are answered.
Department of Paediatrics and Neonatal Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK.
M
M
Silverman
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000503:physiopathology; D008171:Lung Diseases / Q000188:drug therapy* / Q000503:physiopathology
D000305:Adrenal Cortex Hormones; D003907:Dexamethasone