Current Use of Dexamethasone Rescue Therapy for Bronchopulmonary Dysplasia.

Jung,  Euiseok; Ahn,  Yo Han; Lee,  Ju Young; Kim,  Yoon Joo; Son,  Se hyung; Sohn,  Jin A; Lee,  Eunhee; Choi,  Eun Jin; Kim,  Eun Sun; Lee,  Hyun Ju; Lee,  Jin A; Choi,  Chang Won; Kim,  Ee Kyung; Kim,  Han Suk; Kim,  Beyong Il; Choi,  Jung Hwan

Original Article

Journal of the Korean Society of Neonatology 2009;16(2):146-153.
Published online November 1, 2009.

Current Use of Dexamethasone Rescue Therapy for Bronchopulmonary Dysplasia.

Euiseok Jung, Yo Han Ahn, Ju Young Lee, Yoon Joo Kim, Se hyung Son, Jin A Sohn, Eunhee Lee, Eun Jin Choi, Eun Sun Kim, Hyun Ju Lee, Jin A Lee, Chang Won Choi, Ee Kyung Kim, Han Suk Kim, Beyong Il Kim, Jung Hwan Choi

Division of Neonatology, Department of Pediatrics, College of Medicine Seoul National University, Seoul, Korea. kimhans@snu.ac.kr

기관지폐 이형성증에 대한 덱사메타손 구제 치료

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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.

Key Words: Bronchopulmonary dysplasia; Dexamethasone; Pulmonary arterial hypertension; Preterm infant