J Korean Soc Neonatol.  2009 Nov;16(2):146-153.

Current Use of Dexamethasone Rescue Therapy for Bronchopulmonary Dysplasia

• Jung E
• Ahn YH
• Lee JY
• Kim YJ
• Son SH
• Sohn JA
• Lee E
• Choi EJ
• Kim ES
• Lee HJ
• Lee JA
• Choi CW
• Kim EK
• Kim HS
• Kim BI
• Choi JH

Abstract

PURPOSE
The aim of this study is to investigate the current use of dexamethasone rescue therapy (DRT) for bronchopulmonary dysplasia (BPD).
METHODS
This is a retrospective study of 251 BPD patients managed in the neonatal intensive care units at Seoul National University Childrens Hospital and Seoul National University Bundang Hospital between March 2004 and August 2008. The demographic data and clinical characteristics of the mothers and infants were analyzed. The infants were compared based on DRT responsiveness. The DRT complications were investigated. RESLUTS: Ninety-three patients (37.1%) were classified with severe BPD, DRT was only given to patients with severe BPD. Dexamethasone was administered to 24 patients (9.6%) whose respiratory status had precluded extubation, which indicated that conventional BPD management had failed. Fourteen patients (58.3%) who received DRT were responsive. DRT non-responders required more oxygenation and more complicated with pulmonary arterial hypertension (PAH). Responder had shorter length's of hospitalization and lower mortality rates. High dose dexamethasone was no more effective in weaning neonates from the ventilatior than low dose dexamethasone. Sepsis was the most common complication of DRT.
CONCLUSION
DRT is a valuable treatment for severe BPD ahead of PAH development. DRT should not be performed in BPD patients with PAH due to the possibility of complications.

Keyword

Bronchopulmonary dysplasia; Dexamethasone; Pulmonary arterial hypertension; Preterm infant

MeSH Terms

Bronchopulmonary Dysplasia
Child
Dexamethasone
Hospitalization
Humans
Hypertension
Hypertension, Pulmonary
Infant
Infant, Newborn
Infant, Premature
Intensive Care Units, Neonatal
Mothers
Oxygen
Retrospective Studies
Sepsis
Weaning
Dexamethasone
Hypertension, Pulmonary
Oxygen