Postnatal betamethasone vs dexamethasone in premature infants with bronchopulmonary dysplasia: a pilot study.

OBJECTIVE: As effects of glucocorticoids differ with respect to preparation, dose and duration, we hypothesized that a postnatal regimen of a low-dose, short-course betamethasone treatment had comparable efficacy and a better safety profile compared to the conventional high-dose, dexamethasone. STUD...

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Published in:Journal of Perinatology Vol. 29; no. 4; pp. 297 - 305
Main Authors: DeCastro M, El-Khoury N, Parton L, Ballabh P, LaGamma EF
Format: equations & formulas research tables/charts Journal Article
Published: Springer Nature Apr2009
Online Access:View this record in EBSCOhost
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      dt: Apr2009
      vid: 29
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      pub: Springer Nature
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        atl: Postnatal betamethasone vs dexamethasone in premature infants with bronchopulmonary dysplasia: a pilot study.
      aug:
        au:
          DeCastro M
          El-Khoury N
          Parton L
          Ballabh P
          LaGamma EF
        affil: Division of Newborn Medicine, Department of Pediatrics, Regional Neonatal Center, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, NY 10595, USA.
      sug:
        subj:
          Betamethasone Therapeutic Use
          Bronchopulmonary Dysplasia Drug Therapy
          Dexamethasone Therapeutic Use
          Analysis of Variance
          Bronchopulmonary Dysplasia Physiopathology
          Descriptive Statistics
          Female
          Fisher's Exact Test
          Infant, Premature
          Intensive Care Units, Neonatal
          Male
          Mann-Whitney U Test
          Pilot Studies
          Record Review
          Respiration, Artificial
          T-Tests
          Human
          Female
          Male
      ab: OBJECTIVE: As effects of glucocorticoids differ with respect to preparation, dose and duration, we hypothesized that a postnatal regimen of a low-dose, short-course betamethasone treatment had comparable efficacy and a better safety profile compared to the conventional high-dose, dexamethasone. STUDY DESIGN: To test our hypothesis, we selected premature neonates with a birth weight <or=1000 g and a gestational age <or=29 weeks who were ventilated >10 postnatal days with an FiO(2)>0.4 and no ability to wean mechanical support for >or=3 consecutive days. These neonates either received twice daily dexamethasone 0.25 mg kg(-1) per dose intravenously for 3 days tapered to 0.125 mg kg(-1) per dose for 4 days (June 1999 to December 2000) or betamethasone 0.125 mg kg(-1) per day intramuscularly once per day for 3 days (January 2001 to December 2002). RESULT: We found a significant reduction in FiO(2) after 3 days in both glucocorticoid treatment groups. There were no significant differences between the two treatment groups in the clinical parameters including decrease in FiO(2), oxygenation index, mean airway pressure and percent extubation. Duration of ventilation, number of oxygen days and length of hospital stay were comparable in the two groups. Of particular interest, the betamethasone group showed fewer adverse effects, such as poor weight gain and high blood glucose, than the dexamethasone group. CONCLUSION: A short course of low-dose betamethasone has comparable efficacy and seemingly a better short-term safety profile compared to conventional dexamethasone treatment.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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