Sfurti Nath1, Anne Marie Reynolds2, Satyan Lakshminrusimha3, ChangXing Ma4, Mark L Hudak5, Rita M Ryan6. 1. Division of Neonatology, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida. 2. Division of Neonatal-Perinatal Medicine, Women & Children's Hospital of Buffalo, Buffalo, New York. 3. Department of Pediatrics, UC Davis Children's Hospital, Sacramento, California. 4. Department of Biostatistics, School of Public Health, State University of New York at Buffalo, Buffalo, New York. 5. Department of Pediatrics, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida. 6. Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina.
Abstract
OBJECTIVE: This study aimed to compare short-term respiratory outcomes of three steroids (dexamethasone, hydrocortisone, and methylprednisolone) to facilitate extubation by improving respiratory status in preterm infants. STUDY DESIGN: This is a retrospective, single-center, cohort study of 98 intubated preterm infants ≤346/7 weeks' gestation, admitted to a 64-bed, level III neonatal intensive care unit at the Women & Children's Hospital of Buffalo, Buffalo, NY, between 2006 and 2012, who received a short course of low-dose steroids for lung disease after first week of life. RESULTS: Study infants received dexamethasone (34%), hydrocortisone (44%), or methylprednisolone (22%) based on clinical team preference. By day 7 after initiation of steroids, extubation occurred in 59, 44, and 41%, respectively, in infants on dexamethasone, hydrocortisone, and methylprednisolone (p = 0.3). The mean respiratory severity score (RSS = fraction of inspired oxygen × mean airway pressure), a quantitative measure of respiratory status, decreased by 44% for all infants and by 59% in the dexamethasone group by day 7. CONCLUSION: Steroids improved short-term respiratory outcomes in all infants (RSS and extubation); by day 7, dexamethasone treatment was associated with the greatest decrease in RSS. Additional prospective, randomized trials of short-course low-dose steroids are warranted to substantiate these findings to guide clinical decision making and in evaluating differential steroid effects on long-term neurodevelopmental outcomes. Thieme. All rights reserved.
OBJECTIVE: This study aimed to compare short-term respiratory outcomes of three steroids (dexamethasone, hydrocortisone, and methylprednisolone) to facilitate extubation by improving respiratory status in preterm infants. STUDY DESIGN: This is a retrospective, single-center, cohort study of 98 intubated preterm infants ≤346/7 weeks' gestation, admitted to a 64-bed, level III neonatal intensive care unit at the Women & Children's Hospital of Buffalo, Buffalo, NY, between 2006 and 2012, who received a short course of low-dose steroids for lung disease after first week of life. RESULTS: Study infants received dexamethasone (34%), hydrocortisone (44%), or methylprednisolone (22%) based on clinical team preference. By day 7 after initiation of steroids, extubation occurred in 59, 44, and 41%, respectively, in infants on dexamethasone, hydrocortisone, and methylprednisolone (p = 0.3). The mean respiratory severity score (RSS = fraction of inspired oxygen × mean airway pressure), a quantitative measure of respiratory status, decreased by 44% for all infants and by 59% in the dexamethasone group by day 7. CONCLUSION:Steroids improved short-term respiratory outcomes in all infants (RSS and extubation); by day 7, dexamethasone treatment was associated with the greatest decrease in RSS. Additional prospective, randomized trials of short-course low-dose steroids are warranted to substantiate these findings to guide clinical decision making and in evaluating differential steroid effects on long-term neurodevelopmental outcomes. Thieme. All rights reserved.
Authors: Rita M Ryan; Manjeet K Paintlia; Danforth A Newton; Demetri D Spyropoulos; Matthew Kemp; Alan H Jobe; John E Baatz Journal: Am J Physiol Lung Cell Mol Physiol Date: 2021-10-20 Impact factor: 5.464
Authors: Zeyar T Htun; Elizabeth V Schulz; Riddhi K Desai; Jaime L Marasch; Christopher C McPherson; Lucy D Mastrandrea; Alan H Jobe; Rita M Ryan Journal: J Perinatol Date: 2021-05-19 Impact factor: 2.521