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Bronchopulmonary dysplasia and corticosteroid therapy: a case review
Insights
Corticosteroids treat chronic lung disease in newborns by reducing inflammation. However, caregivers must monitor for potential side effects like sepsis and hypertension.
Area of Science:
- Neonatal Medicine
- Pharmacology
- Pulmonology
Background:
- Corticosteroid use for chronic lung disease (CLD) is rising in neonatal intensive care units.
- Steroids reduce pulmonary inflammation, improving lung function and extubation success.
- Potential adverse effects include sepsis, hypertension, glucosuria, and gastrointestinal bleeding.
Abstract:
The use of corticosteroids as a treatment for chronic lung disease is increasing in newborn intensive care units. The anti-inflammatory mechanism of steroids suppresses the pulmonary inflammatory response, leading to improved pulmonary compliance and often a successful extubation. However, side effects, including sepsis, hypertension, glucosuria, and heme positive stools, have been reported. Caregivers must appreciate the multisystem biochemical effects of corticosteroids and anticipate the potential side effects when administering this medication. The article reviews the biochemical processes of dexamethasone, a synthetic corticosteroid, and presents a case study of an infant receiving dexamethasone. A question-and-answer format is interpolated throughout the case study and is intended to challenge the reader's knowledge of the pathophysiology of chronic lung disease and the biochemical actions of corticosteroids. Implications for nursing assessment and management of infants receiving this medication are reviewed.