LOWER RESPIRATORY ILLNESS IN INFANTS AND YOUNG-CHILDREN WITH CYSTIC-FIBROSIS - EVALUATION OF TREATMENT WITH INTRAVENOUS HYDROCORTISONE

The purpose of our study was to assess the effect on pulmonary functio n of adding intravenous hydrocortisone to the standard treatment of in fants with cystic fibrosis (CF) hospitalized for lower respiratory ill nesses (LRI). Twenty CF infants were randomized and received 10 days o f hydrocortisone (10 mg/kg/day) or placebo in addition to standard tre atment with intravenous antibiotics, chest physiotherapy, and an aeros olized beta-agonist with cromolyn. Functional residual capacity (FRC) and forced expiratory flows (V'(max,FRC)) were measured on admission, on Day 10 of hospitalization, and as outpatients 1-2 months following hospital discharge. Pulmonary function values were adjusted for differ ences in body length and expressed as Z-scores. Upon admission, flows were decreased, and FRC was increased in both groups; there were no di fferences between the groups. The change in pulmonary function from ad mission to Day 10 of hospitalization was not different for the two gro ups. From admission to outpatient follow-up after hospitalization, the re was a significant increase in flows for the steroid group, but not for the placebo group. In addition, the direction of change in FRC was significantly different for the two groups; the steroid group had a s mall decrease in FRC, while the placebo group had a small increase in FRC. These findings suggest that the addition of intravenous hydrocort isone to the standard treatment of CF infants hospitalized for a LRI m ay produce a greater or a more sustained improvement in lung function following hospitalization. (C) 1997 Wiley-Liss, Inc.