CLINICAL EFFECTS OF DEXAMETHASONE IN PRET ERM INFANTS AT RISK FOR BRONCHOPULMONARY DYSPLASIA

Objectives: Dexamethasone facilitates an earlier weaning from mechanic al ventilation in infants with bronchopulmonary dysplasia. We have eva luated the clinical effects of dexamediasone in surfactant-treated pre term infants who could not be extubated within 14 days of postnatal ag e. Methods: Effects of Dexamethasone on lung mechanics, gas exchange, chest-X-rays, blood pressure, fluid balance and weight gain was invest igated in 16 preterm infants (mean birth weight 919 +/- 111 g). For st udies of lung mechanics a pneumotachographic system was used (PEDS). R esults: Following treatment with dexamethasone compliance and tidal vo lume significantly increased, resistance decreased. In addition, there was a decrease of oxygen requirements and mean airway pressure decrea sed. Lung opacification in chest-X-rays was reduced. Urine production and mean arterial blood pressure increased. Compared to controls, weig ht gain was delayed. Conclusions: Dexamethasone improves lung mechanic s and gas exchange in preterm infants at risk for chronic lung disease . Reduced lung opacification and increased urine production suggest th at the cause of this improvement may be due to a reduction of pulmonar y fluid.