Growth effects of systemic versus inhaled steroids in chronic lung disease.
OBJECTIVE
To compare the effects of inhaled and systemic steroids on growth in very low birthweight (VLBW) infants with chronic lung disease (CLD).


METHODS
Sixteen babies with CLD randomly received inhaled budesonide (100 microg four times daily for 10 days via Aerochamber) or systemic steroids (dexamethasone 0.5 mg/kg/day, reducing over nine days). Linear growth (lower leg length, LLL) was measured by knemometry twice weekly.


RESULTS
The gestational age, birth weight, postnatal age, and LLL velocity (LLLvel) were similar between the two groups at the start of treatment. At the end of the treatment period, LLLvel was reduced in the dexamethasone group (mean -0.01 mm/day) but had increased in the budesonide group (mean 0.48 mm/day). Mean weight gain was non-significantly lower in the dexamethasone group (5.8 g/kg/day) compared to the budesonide group (mean 12.7 g/kg/day).


CONCLUSIONS
Inhaled budesonide has less short term effects on growth than systemically administered dexamethasone.
Nicholl
R M
RM
Children Nationwide Regional Neonatal Intensive Care Centre, King's College Hospital, London, UK. drnicholl@aol.com
Greenough
A
A
King
M
M
Cheeseman
P
P
Gamsu
H R
HR
D000280:Administration, Inhalation; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000009:adverse effects*; D019819:Budesonide / Q000008:administration & dosage / Q000009:adverse effects*; D002908:Chronic Disease; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects*; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006130:Growth Disorders / Q000139:chemically induced*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D019102:Infant, Very Low Birth Weight; D008171:Lung Diseases / Q000188:drug therapy*; D015430:Weight Gain
D001993:Bronchodilator Agents; D005938:Glucocorticoids; D019819:Budesonide; D003907:Dexamethasone