BRONCHOPULMONARY DYSPLASIA - VALUE OF CORTICOSTEROID-THERAPY

The effects of corticosteroid therapy (betamethasone) during the first postnatal month were evaluated in a prospective study conducted from December 1989 through October 1991 in 33 preterm infants (< 34 weeks gestational age) with bronchopulmonary dysplasia. A group of 47 historical controls (1987 and 1988) who had comparable perinatal and respiratory characteristics but were not treated with steroids was assembled retrospectively to enable comparisons of ventilation duration. Steroid therapy was associated with a significant 7.5-day reduction in duration of mechanical ventilation (33.2 +/- 1 0 versus 40.7 +/- 14.5 days, p < 0.05) and with a higher extubation rate (75.7 % within the first week and 84.8 % in all). Improvements in respiratory function with significant decreases in ventilatory parameters (FiO2, mean airway pressure, and ventilation index) occurred as early as the third treatment day. These improvements were accompanied with a significant reduction in body weight reflecting increased urinary output and reduction of pulmonary interstitial edema. Treatment related adverse events included early, transient arterial hypertension (6/33), hyperglycemia (3/33), and sepsis (7/33).