title: Respiratory Support for Very Low Birth Weight Infants Receiving Dexamethasone.
abstract: To assess how neonatal intensive care units followed the American Academy of Pediatrics guidelines for use of dexamethasone in preterm infants by evaluating respiratory support at the time of dexamethasone administration.
  
  
  
  This is an observational study of infants discharged from one of 290 neonatal intensive care units from 2003 to 2010. The cohort included very low birth weight (<1500 g birth weight) infants born at ≤32 weeks gestational age. The main outcome was respiratory support at time of exposure to dexamethasone. Significant respiratory support was defined as invasive respiratory support (conventional or high-frequency ventilation) with a fraction of inspired oxygen (FiO2) > 0.3.
  
  
  
  Of 81 292 infants; 7093 (9%) received dexamethasone. At the time that dexamethasone was initiated, 4604 (65%) of infants were on significant respiratory support.
  
  
  
  In accordance with the American Academy of Pediatrics recommendations, a majority of infants were on significant respiratory support when receiving dexamethasone, yet a substantial number of infants still received dexamethasone on less than significant respiratory support. Further research on reducing dexamethasone use in premature infants is required to decrease the risk of neurodevelopmental impairment.
authors.affiliation: Massachusetts General Hospital for Children, Boston, MA.
authors.forename: Yamini V
authors.initials: YV
authors.lastname: Virkud
authors.affiliation: Duke Clinical Research Institute, Duke University, Durham, NC.
authors.forename: Christoph P
authors.initials: CP
authors.lastname: Hornik
authors.affiliation: Clemson University, Clemson, SC.
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Benjamin
authors.affiliation: University of North Carolina, Chapel Hill, NC.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Laughon
authors.affiliation: Pediatrix Medical Group, Sunrise, FL.
authors.forename: Reese H
authors.initials: RH
authors.lastname: Clark
authors.affiliation: Duke Clinical Research Institute, Duke University, Durham, NC.
authors.forename: Rachel G
authors.initials: RG
authors.lastname: Greenberg
authors.affiliation: Duke Clinical Research Institute, Duke University, Durham, NC. Electronic address: brian.smith@duke.edu.
authors.forename: P Brian
authors.initials: PB
authors.lastname: Smith
mesh_terms: D000704:Analysis of Variance; D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003907:Dexamethasone / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods*; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D003907:Dexamethasone
keywords: bronchopulmonary dysplasia; chronic lung disease; dexamethasone; very low birth weight