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KMID : 0438520090160020146
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Journal of the Korean Society of Neonatology
2009 Volume.16 No. 2 p.146 ~ p.153
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Current Use of Dexamethasone Rescue Therapy for Bronchopulmonary Dysplasia.
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Jung Eui-Seok
Lee Jin-A
Chol Chang-Won
Kim Ee-Kyung
Choi Jung-Hwan
Kim Han-Suk
Kim Eun-Sun
Kim Beyong-Il
Lee Hyun-Ju
Ahn Yo-Han
Lee Ju-Young
Kim Yoon-Joo
Son Se-Hyung
Sohn Jin-A
Lee Eun-Hee
Choi Eun-Jin
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Abstract
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Purpose: The aim of this study is to investigate the current use of dexamethasone rescue therapy (DRT) for bronchopulmonary dysplasia (BPD).
Methods: This is a retrospective study of 251 BPD patients managed in the neonatal intensive care units at Seoul National University Childrens Hospital and Seoul National University Bundang Hospital between March 2004 and August 2008. The demographic data and clinical characteristics of the mothers and infants were analyzed. The infants were compared based on DRT responsiveness. The DRT complications were investigated.
Results: Ninety-three patients (37.1%) were classified with severe BPD, DRT was only given to patients with severe BPD. Dexamethasone was administered to 24 patients (9.6%) whose respiratory status had precluded extubation, which indicated that conventional BPD management had failed. Fourteen patients (58.3%) who received DRT were responsive. DRT non-responders required more oxygenation and more complicated with pulmonary arterial hypertension (PAH). Responder had shorter length’s of hospitalization and lower mortality rates. High dose dexamethasone was no more effective in weaning neonates from the ventilatior than low dose dexamethasone. Sepsis was the most common complication of DRT.
Conclusion: DRT is a valuable treatment for severe BPD ahead of PAH development. DRT should not be performed in BPD patients with PAH due to the possibility of complications.
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KEYWORD
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Bronchopulmonary dysplasia, Dexamethasone, Pulmonary arterial hypertension, Preterm infant
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