Early administration of inhaled corticosteroids for preventing chronic lung disease in ventilated very low birth weight preterm neonates

Shah, Vibhuti; Ohlsson, Arne; Halliday, Henry L.; Dunn, M

doi:10.1002/14651858.cd001969

Cited by 55 publications

(55 citation statements)

References 22 publications

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“…[18] When inhaled steroid was used as an alternative strategy to prevent and treat BPD, there was no beneficial effect. [19,20] Infants with BPD have elements of fluid retention and reactive airways; however diuretics, [21,22] and bronchodilators, [23] do not prevent the development of BPD. The use of caffeine has recently emerged as a new strategy.…”

Section: Introductionmentioning

confidence: 99%

Respiratory management of extremely low birth weight infants: survey of neonatal specialists

Parat

Mhanna

2016

World J Pediatr

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Variability in treatment strategies of ELBW is common among neonatal specialists. However, the majority of the respondents agreed or strongly agreed to use early CPAP for the management of RDS, consider a FiO2 ≥0.4 and a MAP ≥10 cm H2O as criteria for surfactant therapy, and sometimes or almost always used caffeine to prevent BPD. Steroids continue to have a role in the management of BPD in infants who are difficult to extubate.

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Section: Introductionmentioning

confidence: 99%

Respiratory management of extremely low birth weight infants: survey of neonatal specialists

Parat

Mhanna

2016

World J Pediatr

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“…Use of inhaled steroids has not been encouraging. A systematic review of 5 randomized trials of corticosteroid administered with metered dose inhalers showed no benefits apart from a reduction in the use of systemically administered steroids, 29 and a large trial comparing inhaled budesonide and systemically administered dexamethasone suggested that the inhaled drug was less effective in preventing CLD, although it was safer in terms of other adverse outcomes. 30 However, use of nebulized corticosteroid has been associated with earlier extubation 31 and may warrant additional study.…”

Section: Discussionmentioning

confidence: 99%

Randomized, Controlled Trial of Dexamethasone in Neonatal Chronic Lung Disease: 13- to 17-Year Follow-up Study: I. Neurologic, Psychological, and Educational Outcomes

Jones

2005

Pediatrics

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Information was obtained for 150 adolescents randomized to receive dexamethasone or placebo for neonatal chronic lung disease. Rates of disabilities and educational difficulties were high, but with no significant differences between the 2 groups. Some use of open-label steroids in the placebo group plus losses to long-term follow-up monitoring reduced the power of this study to detect clinically important differences, and this study cannot rule out a real increase in cerebral palsy, as reported by others.

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“…56 Currently, there is no evidence that early inhaled corticosteroids confer important advantages over systemic steroids in the prevention of BPD. 57,58 Future investigations are warranted assessing benefit and harm of steroid 'substitution' in groups of infants whose cortisol levels are low. 59 Ureaplasma urealyticum and erythromycin Ureaplasma urealyticum (U. urealyticum) and its association with BPD has remained controversial for almost the last two decades although numerous studies have focused on this issue.…”

Section: Corticosteroidsmentioning

confidence: 99%

Prevention and treatment of bronchopulmonary dysplasia: current status and future prospects

Thomas

Speer

2007

J Perinatol

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This review summarizes the existing evidence for potential non-ventilatordependent strategies to prevent or ameliorate bronchopulmonary dysplasia (BPD). Oxygen plays an important pathogenetic and therapeutic role for BPD. Targeting infants with lower saturation of peripheral oxygen levels than traditionally used seems justified. Inhaled nitric oxide has not proven effective on pulmonary outcome in extremely low birth weight infants. Diuretics can ameliorate lung function transiently. High intramuscular doses of vitamin A reduce the risk of BPD. Prophylactic application of natural surfactant may also confer benefits. Recently, early administration of caffeine has been shown to decrease risk of BPD. However, assessment of long-term effects is needed before routine use can be recommended. Owing to potential short-and long-term effects, postnatal corticosteroids should be restricted to the most severe manifestations of BPD. Superoxide dismutase and a1-proteinase inhibitor have not shown efficacy in preventing BPD. The potential role of anti-inflammatory therapies like Clara Cell 10 kDa protein has yet to be defined.

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Early administration of inhaled corticosteroids for preventing chronic lung disease in ventilated very low birth weight preterm neonates

Cited by 55 publications

References 22 publications

Respiratory management of extremely low birth weight infants: survey of neonatal specialists

Respiratory management of extremely low birth weight infants: survey of neonatal specialists

Randomized, Controlled Trial of Dexamethasone in Neonatal Chronic Lung Disease: 13- to 17-Year Follow-up Study: I. Neurologic, Psychological, and Educational Outcomes

Prevention and treatment of bronchopulmonary dysplasia: current status and future prospects

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