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• February 2, 2023

A Dose-Limited Dexamethasone and Bubble Continuous Positive Airway Pressure in Ventilation-Dependent Extremely Premature Infants

A Dose-Limited Dexamethasone and Bubble Continuous Positive Airway Pressure in Ventilation-Dependent Extremely Premature Infants

  In this article, authors claim that, although bubble CPAP was proven to be associated with reduced chronic lung disease in the preterm infants, non-invasive respiratory interventions were not always successful in infants <750g. They add that, postnatal steroids, such as dexamethasone, has been associated with early extubation and shorter duration of mechanical ventilation in preterm infants, however, high doses or prolonged courses of dexamethasone may be associated with poor neurodevelopmental outcomes. In this observational cohort, authors assessed a low-dose short dexamethasone course (overall cumulative dose of 0.875g over three days) combined with post extubation bubble CPAP intervention on rates of successful extubation (no re-intubation for 7 days) in extremely preterm infants BW <750 g). They found that, among infants intubated for at least 10 days, the median time to extubation if such limited dose short course of dexamethasone was used, was 2 days (interquartile range: 1-3). In such cohort, total duration of intubation was significantly shorter in infants who received dexamethasone compared with the control groups (21 ± 6 vs. 30 ± 10 days, p = 0.03), and although statistically nonsignificant, the duration to wean to 21% bCPAP was shorter compared with the control group (48 ± 13 vs. 74 ± 29 days, p = 0.06). They conclude that a low-dose short dexamethasone course combined with post extubation bubble CPAP intervention may be associated with successful early extubation and shorter duration of mechanical ventilation. Mohamed MA, Bergman A, Abdelatif D, Massa-Buck B. A Dose-Limited Dexamethasone and Bubble Continuous Positive Airway Pressure in Ventilation-Dependent Extremely Premature Infants. Am J Perinatol. 2022 Sep 26. doi: 10.1055/a-1927-0619. Epub ahead of print. PMID: 35981559. Read more: https://pubmed.ncbi.nlm.nih.gov/35981559/

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