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Retrospective Analysis of Short-Term Respiratory Outcomes of Three Different Steroids Used in Clinical Practice in Intubated Preterm Infants
- Source :
- American journal of perinatology. 37(14)
- Publication Year :
- 2019
-
Abstract
- Objective This study aimed to compare short-term respiratory outcomes of three steroids (dexamethasone, hydrocortisone, and methylprednisolone) to facilitate extubation by improving respiratory status in preterm infants.Study Design This is a retrospective, single-center, cohort study of 98 intubated preterm infants ≤346/7 weeks' gestation, admitted to a 64-bed, level III neonatal intensive care unit at the Women & Children's Hospital of Buffalo, Buffalo, NY, between 2006 and 2012, who received a short course of low-dose steroids for lung disease after first week of life.Results Study infants received dexamethasone (34%), hydrocortisone (44%), or methylprednisolone (22%) based on clinical team preference. By day 7 after initiation of steroids, extubation occurred in 59, 44, and 41%, respectively, in infants on dexamethasone, hydrocortisone, and methylprednisolone (p = 0.3). The mean respiratory severity score (RSS = fraction of inspired oxygen × mean airway pressure), a quantitative measure of respiratory status, decreased by 44% for all infants and by 59% in the dexamethasone group by day 7.Conclusion Steroids improved short-term respiratory outcomes in all infants (RSS and extubation); by day 7, dexamethasone treatment was associated with the greatest decrease in RSS. Additional prospective, randomized trials of short-course low-dose steroids are warranted to substantiate these findings to guide clinical decision making and in evaluating differential steroid effects on long-term neurodevelopmental outcomes.
- Subjects :
- Pediatrics
medicine.medical_specialty
Neonatal intensive care unit
Hydrocortisone
Anti-Inflammatory Agents
New York
Gestational Age
Infant, Premature, Diseases
Methylprednisolone
Severity of Illness Index
Dexamethasone
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
030225 pediatrics
Intensive Care Units, Neonatal
medicine
Humans
030212 general & internal medicine
Bronchopulmonary Dysplasia
Retrospective Studies
Respiratory Distress Syndrome, Newborn
business.industry
Infant, Newborn
Obstetrics and Gynecology
medicine.disease
Treatment Outcome
Bronchopulmonary dysplasia
Pediatrics, Perinatology and Child Health
Gestation
Female
Steroids
business
Infant, Premature
medicine.drug
Cohort study
Subjects
Details
- ISSN :
- 10988785
- Volume :
- 37
- Issue :
- 14
- Database :
- OpenAIRE
- Journal :
- American journal of perinatology
- Accession number :
- edsair.doi.dedup.....99799a1ef35aa461bce8048c52e268d9