A follow-up study of preterm infants given budesonide using surfactant as a vehicle to prevent chronic lung disease in preterm infants.
OBJECTIVE
Our study of early intratracheal instillation of budesonide using surfactant as vehicle showed a significant decrease in death or chronic lung disease (CLD) in preterm infants with severe respiratory distress syndrome (RDS). We now report the long-term outcome at about 2 to 3 years of age.


METHODS
Of the 75 potential survivors, 67 (90%) were studied (35 budesonide-treated, 32 control). All infants had birth weight <1500 g and had severe RDS requiring intermittent mechanical ventilation shortly after birth. The treated group received a mixture of budesonide and surfactant every 8 hours. The control group received only surfactant.


RESULTS
The physical growth and the neurological examinations were comparable between the groups at follow-up. Infants in the group treated with budesonide tended to have higher PDI and MDI scores than infants in the control group (79 +/- 20 vs 74 +/- 18 and 80 +/- 19 vs 75 +/- 20), but these differences were not statistically significant. The incidence of neurodevelopmental impairment was 11 (31%) in the treated group and 13 (40%) in the control group (P = .367).


CONCLUSIONS
Early intratracheal instillation of budesonide using surfactant as a vehicle significantly improved pulmonary outcome without causing long-term adverse effects.
Division of Developmental and Behavior Pediatrics, College of Medicine, China Medical University, Taichung, Taiwan.
Huang T
HT
Kuo
Hong C
HC
Lin
Chang H
CH
Tsai
I C
IC
Chouc
Tsu F
TF
Yeh
D001688:Biological Products / Q000008:administration & dosage*; D019819:Budesonide / Q000008:administration & dosage*; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004339:Drug Compounding; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007322:Instillation, Drug; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000517:prevention & control*; D011663:Pulmonary Surfactants / Q000008:administration & dosage*; D012189:Retrospective Studies; D013997:Time Factors; D014132:Trachea; D016896:Treatment Outcome
D001688:Biological Products; D005938:Glucocorticoids; D011663:Pulmonary Surfactants; D019819:Budesonide; C072197:beractant