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The effect of early dexamethasone administration on bronchopulmonary dysplasia in preterm infants with respiratory distress syndrome. 1998

J L Tapia, and R Ramírez, and J Cifuentes, and J Fabres, and M E Hübner, and A Bancalari, and M E Mercado, and J Standen, and M Escobar
Departamento de Pediatría, Hospital Clínico Universidad Católica, Santiago, Chile.

OBJECTIVE This study was carried to evaluate the effect of early administration of dexamethasone on the incidence of bronchopulmonary dysplasia (BPD) and/or death in surfactant-treated preterm infants with respiratory distress syndrome (RDS). METHODS In a multicenter, double-blind, placebo-controlled trial, 109 preterm infants with RDS and birth weights between 700 and 1600 gm, who were treated with mechanical ventilation and surfactant, were randomly assigned before 36 hours of life to receive dexamethasone (n = 55) or placebo (n = 54) for 12 days. RESULTS There were no differences in the incidence of BPD and/or death between groups. However, fewer patients in the dexamethasone group were oxygen-dependent at 36 weeks after conception (8% vs 33%, p < 0.05). The dexamethasone group had a lower incidence of necrotizing enterocolitis (0% vs 9%, p < 0.05). The incidence of arterial hypertension, hyperglycemia, and sepsis was not affected by the treatment. Basal and poststimulation serum cortisol levels did not differ between groups. CONCLUSIONS The administration of dexamethasone early in the course of RDS does not decrease the incidence of BPD and/or death in preterm infants. However, dexamethasone may reduce oxygen dependency at 36 weeks after conception.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007234 Infant, Premature A human infant born before 37 weeks of GESTATION. Neonatal Prematurity,Premature Infants,Preterm Infants,Infant, Preterm,Infants, Premature,Infants, Preterm,Premature Infant,Prematurity, Neonatal,Preterm Infant
D008297 Male Males
D011663 Pulmonary Surfactants Substances and drugs that lower the SURFACE TENSION of the mucoid layer lining the PULMONARY ALVEOLI. Surfactants, Pulmonary,Pulmonary Surfactant,Surfactant, Pulmonary
D012121 Respiration, Artificial Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2). Ventilation, Mechanical,Mechanical Ventilation,Artificial Respiration,Artificial Respirations,Mechanical Ventilations,Respirations, Artificial,Ventilations, Mechanical
D012127 Respiratory Distress Syndrome, Newborn A condition of the newborn marked by DYSPNEA with CYANOSIS, heralded by such prodromal signs as dilatation of the alae nasi, expiratory grunt, and retraction of the suprasternal notch or costal margins, mostly frequently occurring in premature infants, children of diabetic mothers, and infants delivered by cesarean section, and sometimes with no apparent predisposing cause. Infantile Respiratory Distress Syndrome,Neonatal Respiratory Distress Syndrome,Respiratory Distress Syndrome, Infant
D001997 Bronchopulmonary Dysplasia A chronic lung disease developed after OXYGEN INHALATION THERAPY or mechanical ventilation (VENTILATION, MECHANICAL) usually occurring in certain premature infants (INFANT, PREMATURE) or newborn infants with respiratory distress syndrome (RESPIRATORY DISTRESS SYNDROME, NEWBORN). Histologically, it is characterized by the unusual abnormalities of the bronchioles, such as METAPLASIA, decrease in alveolar number, and formation of CYSTS. Dysplasia, Bronchopulmonary
D003907 Dexamethasone An anti-inflammatory 9-fluoro-glucocorticoid. Hexadecadrol,Decaject,Decaject-L.A.,Decameth,Decaspray,Dexasone,Dexpak,Hexadrol,Maxidex,Methylfluorprednisolone,Millicorten,Oradexon,Decaject L.A.
D004311 Double-Blind Method A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment. Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked
D005260 Female Females

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