Format

Send to

Choose Destination
J Pediatr. 2017 Apr;183:26-30.e3. doi: 10.1016/j.jpeds.2016.12.035. Epub 2017 Jan 18.

Respiratory Support for Very Low Birth Weight Infants Receiving Dexamethasone.

Author information

1
Massachusetts General Hospital for Children, Boston, MA.
2
Duke Clinical Research Institute, Duke University, Durham, NC.
3
Clemson University, Clemson, SC.
4
University of North Carolina, Chapel Hill, NC.
5
Pediatrix Medical Group, Sunrise, FL.
6
Duke Clinical Research Institute, Duke University, Durham, NC. Electronic address: brian.smith@duke.edu.

Abstract

OBJECTIVE:

To assess how neonatal intensive care units followed the American Academy of Pediatrics guidelines for use of dexamethasone in preterm infants by evaluating respiratory support at the time of dexamethasone administration.

STUDY DESIGN:

This is an observational study of infants discharged from one of 290 neonatal intensive care units from 2003 to 2010. The cohort included very low birth weight (<1500 g birth weight) infants born at ≤32 weeks gestational age. The main outcome was respiratory support at time of exposure to dexamethasone. Significant respiratory support was defined as invasive respiratory support (conventional or high-frequency ventilation) with a fraction of inspired oxygen (FiO2) > 0.3.

RESULTS:

Of 81 292 infants; 7093 (9%) received dexamethasone. At the time that dexamethasone was initiated, 4604 (65%) of infants were on significant respiratory support.

CONCLUSIONS:

In accordance with the American Academy of Pediatrics recommendations, a majority of infants were on significant respiratory support when receiving dexamethasone, yet a substantial number of infants still received dexamethasone on less than significant respiratory support. Further research on reducing dexamethasone use in premature infants is required to decrease the risk of neurodevelopmental impairment.

KEYWORDS:

bronchopulmonary dysplasia; chronic lung disease; dexamethasone; very low birth weight

PMID:
28108103
PMCID:
PMC5368005
DOI:
10.1016/j.jpeds.2016.12.035
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center