Retrospective Analysis of Short-Term Respiratory Outcomes of Three Different Steroids Used in Clinical Practice in Intubated Preterm Infants

Sfurti Nath, Anne Marie Reynolds, Satyan Lakshminrusimha, Changxing Ma, Mark L. Hudak, Rita M. Ryan

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective ?This study aimed to compare short-term respiratory outcomes of three steroids (dexamethasone, hydrocortisone, and methylprednisolone) to facilitate extubation by improving respiratory status in preterm infants. Study Design ?This is a retrospective, single-center, cohort study of 98 intubated preterm infants ≤34 6/7weeks' gestation, admitted to a 64-bed, level III neonatal intensive care unit at the Women & Children's Hospital of Buffalo, Buffalo, NY, between 2006 and 2012, who received a short course of low-dose steroids for lung disease after first week of life. Results ?Study infants received dexamethasone (34%), hydrocortisone (44%), or methylprednisolone (22%) based on clinical team preference. By day 7 after initiation of steroids, extubation occurred in 59, 44, and 41%, respectively, in infants on dexamethasone, hydrocortisone, and methylprednisolone (p = 0.3). The mean respiratory severity score (RSS = fraction of inspired oxygen × mean airway pressure), a quantitative measure of respiratory status, decreased by 44% for all infants and by 59% in the dexamethasone group by day 7. Conclusion ?Steroids improved short-term respiratory outcomes in all infants (RSS and extubation); by day 7, dexamethasone treatment was associated with the greatest decrease in RSS. Additional prospective, randomized trials of short-course low-dose steroids are warranted to substantiate these findings to guide clinical decision making and in evaluating differential steroid effects on long-term neurodevelopmental outcomes.

Original languageEnglish (US)
Pages (from-to)1425-1431
Number of pages7
JournalAmerican journal of perinatology
Volume37
Issue number14
DOIs
StatePublished - Dec 1 2020

Keywords

  • bronchopulmonary dysplasia
  • postnatal steroids
  • preterm infants

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Fingerprint Dive into the research topics of 'Retrospective Analysis of Short-Term Respiratory Outcomes of Three Different Steroids Used in Clinical Practice in Intubated Preterm Infants'. Together they form a unique fingerprint.

Cite this