Chronic lung disease of prematurity: are we too cautious with steroids?

Area of Science:

• Neonatology
• Pediatric Pulmonology
• Pharmacology

Background:

• Chronic lung disease (CLD) of prematurity involves complex pathophysiological processes including inflammation, remodeling, and growth.
• Parenteral corticosteroid therapy has demonstrated clinical and biological effects across various stages of CLD.
• Unanswered questions regarding corticosteroid use in CLD persist, necessitating further investigation.

Purpose of the Study:

• To review the current evidence on parenteral corticosteroid therapy in chronic lung disease of prematurity.
• To identify key unresolved questions regarding the efficacy, safety, and long-term impact of corticosteroid use.
• To provide a cautious perspective on steroid utilization pending further research.

Main Methods:

• Literature review and synthesis of existing evidence on corticosteroid therapy in CLD of prematurity.
• Identification and discussion of critical knowledge gaps and areas for future research.
• Analysis of the potential benefits and risks associated with corticosteroid interventions.

Main Results:

• Evidence supports clinical and biological effects of parenteral corticosteroids at different stages of CLD.
• Significant questions remain regarding risk prediction, optimal dosage, topical efficacy, and long-term outcomes.
• The long-term prognosis of CLD in relation to corticosteroid therapy is not fully elucidated.

Conclusions:

• Parenteral corticosteroids have a role in managing chronic lung disease of prematurity.
• Further research is crucial to address remaining uncertainties about corticosteroid use.
• A cautious approach to steroid therapy is recommended until definitive answers are obtained.