DEXAMETHASONE FOR PULMONARY INTERSTITIAL EMPHYSEMA IN PRETERM INFANTS

The efficacy of a 3-day course of dexamethasone (0.5 mg/kg/day) in 10 preterm infants (less than or equal to 30 weeks gestation) with pulmon ary interstitial emphysema (PIE) was studied in a retrospective case r eview. PIE was diagnosed at a median age of 7.5 days and treatment wit h dexamethasone began at 8.5 days, Seven of the 10 subjects had at lea st 2 days of conservative treatment (lowered mean airway pressure) pre ceding dexamethasone during which the mean airway pressure (MAP), oxyg enation index (OI) and mechanical ventilation index (MVI) were not sig nificantly different although within 3 days of dexamethasone each vari able improved significantly (p < 0.05), Similarly, for all 10 infants, OI and MAP were significantly lower at 3 and 7 days from baseline (p < 0.005). By day 7. FiO(2) (p = 0.022) and MVI (p = 0.011) were signif icantly lower and PIE had resolved on chest X-ray in 7/9 (78%) and imp roved in the remaining 2/9 (22%). Nine of the 10 infants survived to t erm. Three days of dexamethasone was associated with significant clini cal improvement in most of these infants. The mechanism may relate to reduced airway oedema and inflammation and reduced airway obstruction.