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Hydrocortisone use in ventilated extremely preterm infants decreased bronchopulmonary dysplasia with no effects on

Anaïs Renault1, Juliana Patkaï2, Gilles Dassieu1

  • 1Neonatal Intensive Care Unit, CHI Créteil, Créteil, France.

Acta Paediatrica (Oslo, Norway : 1992)
|May 31, 2016
PubMed

Insights

Late hydrocortisone use in ventilated premature infants reduced bronchopulmonary dysplasia (BPD) rates. This intervention showed no significant impact on neurodevelopmental outcomes at two years corrected age.

Area of Science:

  • Neonatalogy
  • Pediatric Pulmonology
  • Neonatal Intensive Care

Background:

  • Extremely premature infants often require prolonged mechanical ventilation.
  • Postnatal corticosteroids are used to manage respiratory distress but carry potential risks.
  • Varied clinical practices exist regarding the timing and type of corticosteroids administered.

Purpose of the Study:

  • To evaluate the impact of late postnatal corticosteroids on outcomes in ventilator-dependent extremely premature infants.
  • To compare outcomes between centers with permissive versus restrictive corticosteroid policies.

Main Methods:

  • Retrospective analysis of inborn infants <27 weeks gestational age, ventilator-dependent >14 days.
  • Comparison between two centers: one permissive (Centre P) and one restrictive (Centre R) for corticosteroid use.
  • Assessment of in-hospital and 2-year corrected age outcomes using multivariable analysis.

Main Results:

  • Centre P (hydrocortisone) had significantly lower bronchopulmonary dysplasia (BPD) rates (30% vs. 71%) compared to Centre R (betamethasone).
  • Permissive corticosteroid use (Centre P) was associated with younger post-conceptional age at oxygen weaning and discharge.
  • No significant difference in poor neurodevelopmental outcomes at 2 years corrected age between centers (18% vs. 30%).

Conclusions:

  • Late hydrocortisone administration in ventilated extremely preterm infants is associated with reduced BPD.
  • No apparent adverse effects on neurodevelopment were observed at two years corrected age with this approach.
Abstract

Keywords:
Bronchopulmonary dysplasiaExtremely low gestational ageHydrocortisoneNeurodevelopmental outcomePostnatal steroids

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