BRONCHOPULMONARY DYSPLASIA - A RETROSPECT IVE ANALYSIS OF DIFFERENT FORMS OF TREATMENTS AND DESIGN OF A GRADUAL THERAPEUTIC REGIME

50 premature infants with bronchopulmonary dysplasia (BPD) were treate d in the Perinatal Center of the University of Heidelberg from January 1990 to December 1992. Gestational age was 24-31 weeks and birthweigh t was 500 to 1430 grams. 27 infants received dexamethasone only and 14 were initially given dexamethasone followed by beclomethasone inhalat ion. Nine infants without assisted ventilation were only treated with inhaled beclomethasone. Infants with fluid intake >150 ml/kg/d and les s than or equal to 150 ml/kg/d were analysed separately. Extubation in ventilated infants was possible 1 to 29 days after the beginning of d examethasone treatment. Mast infants who were not ventilated any more could be weaned from oxygen during the period of dexamethasone treatme nt. Inhaled beclomethasone allowed reduction in supplemental oxygen in all infants. Effects of treatment with dexamethasone and beclomethaso ne were similar in infants with fluid intake of <150 ml/kg/d and >150 ml/kg/d. Our data show that dexamethasone and inhaled beclomethasone i mproved the clinical course of BPD in premature infants. Fluid intake had no influence on clinical outcome. Based on our results, we suggest guidelines for the treatment of BPD.