Early (4-7 days of age) dexamethasone therapy for prevention of chronic lung disease in preterm infants

We conducted a comparative study to evaluate whether early (4-7 days of age ) tow-dose dexamethasone (DEX) therapy in preterm infa nts with surfactant- pretreated respiratory distress syndrome (RDS) would facilitate extubation and improve the clinical outcome. Twenty-six preterm infants with surfactan t-pretreated RDS who were oxygen- and ventilator-dependent at 4 days of pos tnatal age were enrolled. Twelve infants were in the historical comparison group, and 14 infants were assigned to receive DEX 0.125 mg/kg i.v., every 12 h, for a total of 6 doses. At study entry, the two groups had a comparab le clinical status. DEX therapy significantly facilitated weaning from mech anical ventilation (median interval, 6 vs. 24 days, p < 0.005) and shortene d duration of oxygen supplementation (9 vs. 28 days, p < 0.05) as compared with the historical comparison group. At 28 days of age, the occurrence of chronic lung disease (CLD) was significantly lower (1/14 vs. 6/12, p < 0.05 ) and there was a significant decrease in the incidence of ventilator depen dence (0/14 vs. 5/12, p < 0.05) in the DEX group. DEX therapy did not influ ence the incidence of significant complications such as infection, perivent ricular leukomalacia or retinopathy of prematurity. We conclude that in a s elected high-risk group of preterm infants, early low-dose DEX treatment re sults in improvement in pulmonary outcome without significant side effects.