Premium
Corticosteroids and chronic lung disease in extremely immature infants: A dilemma
Author(s) -
Moriette Guy,
Mikaeloff Yann,
Jarreau PierreHenri,
Desfrère Luc
Publication year - 1999
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/(sici)1099-0496(1999)27:18+<209::aid-ppul67>3.0.co;2-m
Subject(s) - medicine , intensive care medicine , pediatrics , dexamethasone , incidence (geometry) , disease , lung disease , lung , physics , optics
What is the balance of benefits and risks of dexamethasone in extremely immature infants? The answer remains unclear. We feel that the risks of "early" treatment outweigh the benefits, because many infants who would not develop CLD will be treated. Treatment between day 7 and day 14 seems more appropriate to us, as it focuses on infants with a high risk of developing CLD. However, the lungs may be already somewhat damaged when starting treatment, whose expected benefit is a shortened duration of mechanical ventilation and a decreased incidence of CLD. The risks for growth and brain development are not clearly assessed. Both 7-day courses and pulse therapy are effective, but no comparison of these 2 schedules has been published. We therefore do not know whether pulse therapy provides the same benefits as 7-day courses with fewer risks for growth or cardiomyopathy.