In preterm infants with bronchopulmonary dysplasia, what are the benefits and harms of initiating treatment with inhaled corticosteroids after the first week of life?

2017 ◽  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Inhaled Corticosteroids

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.

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

scholarly journals Stem cells for bronchopulmonary dysplasia in preterm infants: A randomized controlled phase II trial

2021 ◽  
Author(s):  
So Yoon Ahn ◽  
Yun Sil Chang ◽  
Myung Hee Lee ◽  
Se In Sung ◽  
Byong Sop Lee ◽  
...  
Keyword(s):  
Stem Cells ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Phase Ii ◽  
Phase Ii Trial ◽  
Randomized Controlled

Characterization of lung ultrasound imaging in preterm infants with bronchopulmonary dysplasia

2021 ◽  
pp. 1-13
Author(s):  
Ying-Hua Sun ◽  
Lin Yuan ◽  
Yang Du ◽  
Jian-Guo Zhou ◽  
Sam Bill Lin ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Neonatal Intensive Care ◽  
Lung Ultrasound ◽  
Imaging Method ◽  
Chronic Lung Diseases ◽  
Pleural Line ◽  
Ultrasound Features

BACKGROUND: Lung ultrasound (LUS) is a bedside technique that can be used on diagnosis and follow-up of neonatal respiratory diseases. However, there are rare reports on the ultrasound features of bronchopulmonary dysplasia (BPD) which is one of the most common chronic lung diseases in preterm infants. OBJECTIVE: To describe the ultrasound features of different BPD levels, and to investigate the value of ultrasound in evaluating moderate-to-severe BPD. METHODS: In this prospective cohort study, newborns of less than 37 weeks’ gestational age in neonatal intensive care unit (NICU) were included. The LUS characteristics including pleural line, alveolar-interstitial syndrome (AIS), retrodiaphragmatic hyperechogenicity and diaphragmatic morphology were observed and recorded. The reliability of LUS in evaluating moderate and severe BPD were compared and calculated. RESULTS: A total of 108 infants were enrolled in our study: 39, 24, 29, 16 infants had non, mild, moderate and severe BPD. The median(IQR) pleura thickness in the moderate-to-severe BPD group was 1.7(1.6–1.85) mm, which was thicker than that in the none-to-mild BPD infants (P <  0.001), meanwhile the proportions of rough pleural lines, diffuse AIS, retrodiaphragmatic hyperechogenicity, small cysts above the diaphragm and rough diaphragm in the moderate-to-severe BPD group were also higher than those in none-to-mild BPD group (86.7% vs 36.5, 57.8% vs 7.9%, 37.8% vs 0, 33.3% vs 0, P <  0.001). In evaluating moderate-to-severe BPD, rough pleura had 91.1% (95% confidence interval [CI]: 0.793–0.965) in sensitivity, 91.3% (95% CI: 0.797–0.966) in negative predictive value (NPV), and 66.7% (95% CI: 0.544–0.771) in specificity. Small cysts had 100% (95% CI: 0.941-1) in specificity, 100% (95% CI: 0.816-1) in PPV, and 37.8% in sensitivity (95% CI: 0.251–0.524). Rough diaphragm had 100% (95% CI: 0.943-1) in sensitivity, 100% (95% CI: 0.796-1) in PPV and 33.3% (95% CI: 0.211–0.478) in specificity. CONCLUSIONS: Depending on its unique advantages such as convenient, no radiation and repeatable, LUS is a valuable imaging method in assessing the severity of BPD, especially in moderate and severe BPD.

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