Document Detail


Respiratory and systemic effects of inhaled dexamethasone on ventilator dependant preterm infants at risk for bronchopulmonary dysplasia.
MedLine Citation:
PMID:  10771973     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Short-term inhaled dexamethasone therapy was evaluated in a double blind placebo controlled trial in 36 ventilator dependent preterm neonates (BW < 1500 gm, postnatal age > 7 days) who were at risk for bronchopulmonary dysplasia. Pulmonary and systemic effects were compared at early (day 3), late (7-10 days) and post (14 days after initiation) phases of therapy. Airflow mechanics improved as demonstrated by a net 101% improvement in pulmonary resistance (a decrease from 139 to 101 cm H2O/L/s in the dexamethasone treated infants as compared to an increase from 153 to 267 cmH2O/L/s in the placebo treated infants during the early phase of therapy); this was associated with a 45% increase in inspiratory airflow (1.29 +/- 0.43 to 1.87 +/- 0.978 L/min; p < 0.01), and 37% increase in expiratory airflow. These changes resulted in a significant reduction in the work of breathing such that the mean tidal driving pressure significantly decreased from 13.6 cmH2O to 9.4 cm H2O with inhaled steroid administration. Though the brief duration of therapy did not result in cessation of ventilatory support, the level of support was significantly reduced (decreased values of oxygen supplementation, mean airway pressure and oxygenation index and increased ventilatory efficiency index). The inhaled dexamethasone therapy was also associated with systemic absorption of the drug as evidenced by transient but apparently reversible reduction in serum cortisol levels. No systemic side effects of hypertension, hyperglycemia or nosocomial sepsis were observed. These data demonstrate beneficial effects of short-term inhaled dexamethasone on the resistive airflow properties of preterm infants at risk for BPD and may provide adjunctive means to facilitate weaning in the ventilator dependent neonates.
Authors:
M Pappagallo; S Abbasi; V K Bhutani
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Indian journal of pediatrics     Volume:  65     ISSN:  0019-5456     ISO Abbreviation:  Indian J Pediatr     Publication Date:    1998 Mar-Apr
Date Detail:
Created Date:  2000-05-09     Completed Date:  2000-05-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0417442     Medline TA:  Indian J Pediatr     Country:  INDIA    
Other Details:
Languages:  eng     Pagination:  273-82     Citation Subset:  IM    
Affiliation:
Section on Newborn Pediatrics, Pennsylvania Hospital, Philadelphia 19107, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Airway Resistance / drug effects
Bronchopulmonary Dysplasia / drug therapy*
Dexamethasone / administration & dosage*,  adverse effects
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Lung Volume Measurements
Male
Positive-Pressure Respiration*
Respiratory Distress Syndrome, Newborn / drug therapy*
Ventilator Weaning
Chemical
Reg. No./Substance:
50-02-2/Dexamethasone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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