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Budesonide delivered by dosimetric jet nebulization to preterm very low birthweight infants at high risk for development of chronic lung disease
Author(s) -
Jónsson B,
Eriksson M,
Söder O,
Broberger U,
Lagercrantz H
Publication year - 2000
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2000.tb02775.x
Subject(s) - budesonide , medicine , anesthesia , corticosteroid , placebo , gestational age , nebulizer , dexamethasone , bronchopulmonary dysplasia , inhalation , pregnancy , surgery , alternative medicine , pathology , biology , genetics
We investigated the effect of an aerosolized corticosteroid (budesonide) on the oxygen requirement of infants at high risk for developing chronic lung disease (CLD) in a randomized, double‐blind study. The study objective was to attain a 30% decrease in FiO 2 levels in the budesonide treatment group after 14 d of therapy. Thirty very low birthweight (VLBW) infants (median (range)) gestational age 26 wk (23–29) and birthweight 805 g (525–1227) were randomized. Inclusion criteria were mechanical ventilation on day 6 of life, or if extubated on nasal continuous positive airway pressure with FiO 2 ± 0.3. The budesonide (Pulmicort™ dose was 500 μg bid, or placebo. The aerosol was delivered with a dosimetric jet nebulizer, with variable inspiratory time and breath sensitivity. Inhalations were started on day 7 of life. Twenty‐seven patients completed the study. A significant lowering of the FiO 2 levels at 21 d of life was not detected. Infants who received budesonide were more often extubated during the study period (7/8 vs 2/9) and had a greater relative change from baseline in their oxygenation index (budesonide decreased 26% vs placebo increased 60%). Subsequent use of intravenous dexamethasone or inhaled budesonide in the treatment group was significantly less. All patients required O 2 supplementation on day 28 of life. At 36 wk postconceptual age, 61% of infants in the budesonide group needed supplemental O 2 as opposed to 79% in the placebo group. No side effects on growth or adrenal function were observed Conclusion : We conclude that inhaled budesonide aerosol via dosimetric jet nebulizer started on day 7 of life for infants at high risk for developing CLD decreases the need for mechanical ventilation similar to intravenous dexamethasone, but without significant side effects.