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Journal of the Korean Society of Neonatology 1999;6(1):16-23.
Published online January 1, 2001.
The Effects of Dexamethasone on Blood Pressure in Premature Infants with Bronchopulmonary Dysplasia.
Hyung Chul Choi, So Ra Lee, Hwa In Kim, Yeon Kyun Oh
Department of Pediatrics, College of Medicine, Wonkwang University, Iksan, Korea.
To evaluate the effects of dexamethasone(D) on blood pressure(BP) in infants with bronchopulmonary dysplasia(BPD).
We retrospectively reviewed 10 infants with BPD(mean birth weight: 1,383+/-17 gm, mean gestational age: 29.0+/-1.7 weeks) treated with D at Wonkwang University Hospital from January 1994 to June 1998. D was started at 0.5 mg/kg/day intravenously for first week, followed by 0.3 and 0.1 mg/kg/day for second and third week, respectively. Changes in BP during pre-D, 1st wk(D1), 2ndwk(D2), 3rd wk(D3), and post-D periods were compared using Turkey Kramer multiple comparison test.
Mean systolic pressure(sBP) significantly increased in Dl, D2, D3 compared to pre-D(63+1.3, P<0.01; 66+1.7, P<0.001; 683.4, P<0.001 vs 591.9 mmHg, respectively) but significantly decreased in post-D compared to D3(64+/-2.4 mmHg, P<0.05). Mean diastolic pressure(dBP) significantly increased in D2 and D3 compared to pre-D(42+/-1.1, P<0.001; 43+/-2.6, P<0.001, vs 382.1 mmHg, respectively). Mean dBP deed slightly in post-D(41+/-4.1 mrnHg, P>0.05). The sBP and dBP significantly increased from day 2 after initiation of D and were highest on day 17 and 17-18 of 3rd week, respectively. The number of hypertensive infants who were considered for antihypertensive medications were 2(20%) for sBP >or= 80-90 mmHg, 3(30%) for dBP >or= 50 mmHg and 1(10%) for dBP> or =60 mmHg. These infants, however, remained asymptomatic.
Significant elevation of BP was observed during dexamethasone therapy for infants with BPD especially after 2nd day. However, BP elevation was transient, not requiring antihypertensive medications.
Key Words: Dexamethasone; Blood pressure; Bronchopulmonary dysplasia; Prematurity


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