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Corticosteroids and chronic lung disease in extremely immature infants: A dilemma

✍ Scribed by Guy Moriette; Yann Mikaeloff; Pierre-Henri Jarreau; Luc Desfrère

Publisher
John Wiley and Sons
Year
1999
Tongue
English
Weight
402 KB
Volume
27
Category
Article
ISSN
8755-6863

No coin nor oath required. For personal study only.

✦ Synopsis

What is the balance of benefits and risks of dexamethasone in extremely immature infants? The answer remains unclear. We feel that the risks of "early" treatment outweigh the benefits, because many infants who would not develop CLD will be treated. Treatment between day 7 and day 14 seems more appropriate to us, as it focuses on infants with a high risk of developing CLD. However, the lungs may be already somewhat damaged when starting treatment, whose expected benefit is a shortened duration of mechanical ventilation and a decreased incidence of CLD. The risks for growth and brain development are not clearly assessed. Both 7-day courses and pulse therapy are effective, but no comparison of these 2 schedules has been published. We therefore do not know whether pulse therapy provides the same benefits as 7-day courses with fewer risks for growth or cardiomyopathy.

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