For preterm infants given a diagnosis of bronchopulmonary dysplasia or at high risk of developing this disease, what are the benefits and harms of initiating treatment with inhaled corticosteroids after the first week of life?

2017 ◽  
Author(s):  
Mark Davies
Keyword(s):  
High Risk ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Inhaled Corticosteroids

scholarly journals Use of inhaled corticosteroids for the prevention and/or treatment of bronchopulmonary dysplasia in preterm infants: a systematic review protocol

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Eric S. Shinwell ◽  
Igor Portnov ◽  
Joerg Meerpohl ◽  
Tanja Karen ◽  
Dirk Bassler
Keyword(s):  
Systematic Review ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Inhaled Corticosteroids ◽  
Systematic Review Protocol ◽  
Review Protocol

A Controlled Trial of Dexamethasone in Preterm Infants at High Risk for Bronchopulmonary Dysplasia

1989 ◽  
Vol 320 (23) ◽  
pp. 1505-1510 ◽  
Author(s):  
James J. Cummings ◽  
Diane B. D'Eugenio ◽  
Steven J. Gross
Keyword(s):  
High Risk ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Controlled Trial

scholarly journals Postnatal corticosteroids to prevent or treat bronchopulmonary dysplasia in preterm infants

2020 ◽  
Vol 25 (5) ◽  
pp. 322-326
Author(s):  
Brigitte Lemyre ◽  
Michael Dunn ◽  
Bernard Thebaud
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Inhaled Corticosteroids ◽  
Current Evidence ◽  
Safe Alternative ◽  
Risk Of Mortality ◽  
Short Course ◽  
Increased Risk ◽  
Dexamethasone Therapy ◽  
Physiological Dose

Abstract Historically, postnatal corticosteroids have been used to prevent and treat bronchopulmonary dysplasia (BPD), a significant cause of morbidity and mortality in preterm infants. Administering dexamethasone to prevent BPD in the first 7 days post-birth has been associated with increasing risk for cerebral palsy, while early inhaled corticosteroids appear to be associated with an increased risk of mortality. Neither medication is presently recommended to prevent BPD. New evidence suggests that prophylactic hydrocortisone, when initiated in the first 48 hours post-birth, at a physiological dose, and in the absence of indomethacin, improves survival without BPD, with no adverse neurodevelopmental effects at 2 years. This therapy may be considered by clinicians for infants at highest risk for BPD. Routine dexamethasone therapy for all ventilator-dependent infants is not recommended, but after the first week post-birth, clinicians may consider a short course of low-dose dexamethasone (0.15 mg/kg/day to 0.2 mg/kg/day) for individual infants at high risk for, or with evolving, BPD. There is no evidence that hydrocortisone is an effective or safe alternative to dexamethasone for treating evolving or established BPD. Current evidence does not support inhaled corticosteroids for the treatment of BPD.

scholarly journals Cytokines and Exhaled Nitric Oxide Are Risk Factors in Preterm Infants for Bronchopulmonary Dysplasia

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Zhenjie Zhang ◽  
Wuchen Wu ◽  
Lian Hou ◽  
Jingjing Jiang ◽  
Weilin Wan ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Risk Factors ◽  
Mechanical Ventilation ◽  
High Risk ◽  
Disease Severity ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Exhaled Nitric Oxide ◽  
High Risk Factors ◽  
Tnf Α

Bronchopulmonary dysplasia (BPD) is the most common complication of extremely preterm birth. This study was aimed at detecting cytokine and fractional exhaled nitric oxide (FeNO) levels to evaluate their mechanisms and predicted significance for BPD. Preterm infants born at g e s t a t i o n a l   a g e ≤ 32   w e e k s were recruited, and clinical data were collected. We detected ten cytokines, including IFN-γ, IL-10, IL-12p70, IL-13, IL-1β, IL-2, IL-4, IL-6, IL-8, and TNF-α on Days 1–3, Days 7–14, and Days 21–28 after birth by using the Meso Scale Discovery (MSD) technology. The FeNO levels of infants were measured when they met the discharge criteria. A total of 46 preterm infants were enrolled, consisting of 14 infants in BPD group and 32 infants in the control group. The gestational age ( 27.5 ± 1.3 vs. 29.9 ± 1.3 weeks) and birth weight ( 1021 ± 261  g vs. 1489 ± 357 g) were lower in the BPD group. The following were high-risk factors for BPD, as determined by multivariate logistic regression analysis: g e s t a t i o n a l   a g e < 30   w e e k s , b i r t h   w e i g h t < 1000   g , PDA, longer mechanical ventilation, and higher FeNO. The cytokines of IL-6 and IL-8 on Days 7–14 and IL-4, IL-6, IL-8, and TNF-α on Days 21–28 were also high-risk factors for BPD. IL-6 contributed to BPD disease severity. Conclusion. The preterm infants with PDA and prolonged mechanical ventilation tended to develop BPD. The IL-6 and IL-8 were significantly increased on Days 7–14 and were high-risk factors for BPD. Moreover, the IL-6 level was associated with BPD disease severity. We speculated that NO was related to BPD via Th2 cell-mediated inflammatory responses such as IL-4 and IL-6. Cytokines might predict the occurrence of BPD.

scholarly journals The high-risk factors of different severities of bronchopulmonary dysplasia (BPD) based on the national institute of child health and human development (NICHD) diagnosis criteria in 2018

2021 ◽  
pp. e20210125
Author(s):  
Minqiao Jian1,2 ◽  
Shaoru He1,2 ◽  
Yumei Liu2 ◽  
Xiaoqing Liu3 ◽  
Juan Gui2 ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Klebsiella Pneumoniae ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Ductus Arteriosus ◽  
Severe Illness ◽  
Pulmonary Infections ◽  
High Risk Factors ◽  
Severe Group

Objective: To investigate the clinical characteristics of preterm infants with different severities of bronchopulmonary dysplasia (BPD) and disclose the high-risk factors of exacerbating BPD. Methods: Collection of clinical data of 91 preterm infants admitted to the NICU and diagnosed with BPD, categorized in groups according to the disease severity: 41 mild cases,, 24 moderate cases, and 26 severe cases. Comparison and analysis of perinatal risk factors, treatment, complications and prognosis of the infants with different severity degrees. Results: The severe group had a higher proportion of infants with congenital heart disease (CHD) higher than the moderate group (P < 0.05), and a higher ratio of pneumonia and mechanical ventilation (MV) = seven days than the mild group (P < 0.05). The severe group also presented higher reintubation incidence than both the mild and moderate groups (P < 0.05). The groups presented different (P < 0.05) incidence rates of hemodynamically significant patent ductus arteriosus (hsPDA) . Ridit analysis suggested that the premature infants (PIs) with hsPDA, multiple microbial pulmonary infections, or Klebsiella pneumoniae pneumonia had more severe illness. Conclusion: CHD, hsPDA, MV = seven days, reintubation, pneumonia, especially multiple microbial pulmonary infections, and Klebsiella pneumoniae pneumonia are correlated with the severity of BPD and can be used as BPD progression predictor.

Fluid status in the first 10 days of life and death/bronchopulmonary dysplasia among preterm infants

2021 ◽  
Author(s):  
Safiya Soullane ◽  
Sharina Patel ◽  
Martine Claveau ◽  
Laila Wazneh ◽  
Guilherme Sant’Anna ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Life And Death ◽  
Fluid Status
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