Early versus late dexamethasone treatment in preterm infants at risk for chronic lung disease: a randomized pilot study.
Abstract The purpose of this controlled, prospective pilot study was to compare the short-and long-term efficacy of early versus late treatment with dexamethasone (Dex) in preterm infants at risk for chronic lung disease (CLD). Thirty ventilated premature infants with a birth weight < or = 1250 g were randomized to receive Dex either from day 7 or from day 14. Dex was administered over 16 days tapering from 0.5 mg/kg per day to 0.1 mg/kg per day. The infants of the early treatment group could be weaned significantly earlier from the ventilator after 14 days (median; range 9-24) versus 24 days (median; range 8-44) in the late treatment group. The need for supplemental oxygen was shorter if Dex was started early - 24 days (median; range 10-57) versus 40 days (median; range 10-74). Oxygen dependency at 28 days of age was similar between the groups 6 out of 14 infants (42.9%) versus 10 out of 16 patients (62.5%). The long-term efficacy of the two Dex regimens on lung function was evaluated by body plethysmographic measurements made at the age of 3 months. Thoracic gas volume and airway resistance were measured and specific airway conductance calculated. No statistically significant differences between the groups were demonstrated.


CONCLUSIONS
Early dexamethasone treatment led to earlier extubation in our study population, but was not associated with significant advantages regarding oxygen dependency at 28 days of life and pulmonary function test at 3 months of age.
Merz
U
U
Neonatal Intensive Care Unit, Children's Hospital, University of Technology, Aachen, Germany.
Peschgens
T
T
Kusenbach
G
G
Hörnchen
H
H
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control*; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D018709:Statistics, Nonparametric; D013997:Time Factors
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone