Pulmonary Effects of Neonatal Hydrocortisone Treatment in Ventilator-Dependent Preterm Infants

Background/Objective . Hydrocortisone, administered to ventilated preterm neonates to facilitate extubation, has no adverse long-term effects, but short-term pulmonary effects have not been described previously. In the present study, we analyzed effects of hydrocortisone on ventilator settings and FiO 2 in ventilator-dependent preterm infants. Patients and Methods . Fifty-five preterm children were included in this retrospective cohort study. Hydrocortisone was administered at a postnatal age of > 7 days to treat chronic lung disease (CLD). Ventilator settings before and after hydrocortisone administration were recorded as well as FiO 2 at 36 weeks' gestational age. Presence of cerebral palsy was assessed at a mean corrected age of 24.1 months. Results . Hydrocortisone administered at a median postnatal age of 14 days significantly reduced FiO 2 from a median of 0.39 to 0.30, mean airway pressure (MAP) from a median of 10.0 cm H 2 O to 7.6 cm H 2 O, and PaCO 2 from a median of 53.5 mmHg to 47 mmHg. Extubation was achieved in all patients. CLD at 36 weeks was present in 11 of the 52 patients (21.1%). None developed cerebral palsy. Conclusions . Hydrocortisone was effective in reducing the FiO 2 , MAP, and PaCO 2 and facilitated extubation. Hydrocortisone was not associated with cerebral palsy.