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Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs
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Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs

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Corticosteroids for the prevention of bronchopulmonary dysplasia in preterm infants: a network meta-analysis

Linan Zeng1,2, Jinhui Tian3,4, Fujian Song5

  • 1Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|February 25, 2018
PubMed

Insights

Dexamethasone effectively prevents bronchopulmonary dysplasia (BPD) in preterm infants. Aggressive early use is beneficial, but high-dose, long-term administration may pose neurodevelopmental risks.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Pharmacology

Background:

  • Bronchopulmonary dysplasia (BPD) is a significant complication in preterm infants.
  • Corticosteroids are used to prevent BPD, but their comparative efficacy and safety profiles require clarification.

Purpose of the Study:

  • To compare the efficacy and safety of various corticosteroids for BPD prevention in preterm neonates.
  • To identify optimal corticosteroid regimens for reducing BPD incidence.

Main Methods:

  • Systematic literature search of PubMed, EMBASE, and Cochrane Library.
  • Inclusion of 47 randomized controlled trials (RCTs) involving 6747 preterm infants.
  • Bayesian network meta-analysis and subgroup analyses to assess treatment effects.

Main Results:

  • Dexamethasone, both high- and low-dose, significantly reduced the risk of BPD.
  • High-dose dexamethasone demonstrated superior efficacy compared to hydrocortisone, beclomethasone, and low-dose dexamethasone.
  • Early and long-term dexamethasone use decreased BPD risk, but high-dose, long-term regimens were associated with potential adverse neurodevelopmental outcomes (cerebral palsy).
  • Budesonide showed promise in extremely preterm infants.

Conclusions:

  • Dexamethasone is effective in preventing BPD in preterm infants.
  • Aggressive early initiation of dexamethasone appears beneficial.
  • Avoid high-dose, long-term dexamethasone due to potential neurodevelopmental risks.
  • Further large-scale RCTs with long-term follow-up are needed for dexamethasone and inhaled corticosteroids.
Abstract

Keywords:
bronchopulmonary dysplasiacorticosteroidnetwork meta-analysis

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