Betamethasone impairs cerebral blood flow velocities in very premature infants with severe chronic lung disease.
OBJECTIVE
To assess betamethasone (BM) effects on the cerebral hemodynamics of neonates with severe chronic lung disease (CLD).


METHODS
Intravenous BM was given once daily for 6 consecutive days to 12 infants (birth weight: 698 g [range, 650-884 g], gestational age: 25.3 weeks [range, 25-26.4 weeks]) at a postnatal age of 34 days (range, 28-36 days). Cerebral blood flow velocities (CBFVs) were recorded prospectively in the anterior cerebral artery (ACA) and the lenticulostriate artery (LSA) before, during, and after treatment, using Doppler flowmetry.


RESULTS
The decrease in systolic and diastolic velocities was maximum on the 5th day, reaching 32% (95% confidence interval [CI], 23%-42%) and 58% (95% CI, 39%-64%) from baseline in the ACA, and 44% (95% CI, 29%-50%) and 57% (95% CI, 33%-66%) in the LSA, respectively. The resistance index (RI) increased significantly in both arteries during treatment. Return to baseline values was observed after BM was stopped. The change in velocities and RI was independent of arterial blood gas and blood pressure variations.


CONCLUSIONS
BM decreased the CBFVs of premature infants, suggesting a vasoconstrictor effect in both superficial and deep arterial vessels. Caution is recommended when BM is used to treat preterm infants with severe CLD.
Cambonie
Gilles
G
Neonatal Intensive Care Unit, Arnaud de Villeneuve Hospital, University Hospital of Montpellier, France.
Mesnage
Renaud
R
Milési
Christophe
C
Pidoux
Odile
O
Veyrac
Corinne
C
Picaud
Jean-Charles
JC
D020771:Anterior Cerebral Artery / Q000473:pathology; D001623:Betamethasone / Q000494:pharmacology*; D001776:Blood Circulation Time; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D002908:Chronic Disease; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy; D017078:Laser-Doppler Flowmetry / Q000379:methods; D008171:Lung Diseases / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D011247:Pregnancy
D001623:Betamethasone