Abstract
To determine the changes in pulmonary function before and during dexamethasone (D) therapy in VLBW ventilator dependent infants at high risk for chronic lung disease (CLD), we are conducting a randomized study in infants that failed weaning from mechanical ventilation at 7-14 days of age; 15 patients (bw 620-1000g, ga 25-30 weeks) have been enrolled; 7 infants received a 7 day course of D (0.5mg/Kg/day IV for 3 days, 0.25 mg/Kg/day for 3 days and 0.1 mg/Kg/day for 1 day), and 8 patients were controls(C). At comparable mean airway pressure and FIO2, respiratory compliance (Crs) and resistance (Rrs) were measured before and on days 2, 5 and 7 of D therapy (PeDS). We monitored airway pressure, flew and tidal volume (VT) and analyzed only mechanical breaths.D therapy was associated with a significant reduction of FIO2 and mean airway pressure, a temporary increase in BP was noted in two patients. We conclude that early D therapy in VLBW infants markedly improves Crs and VT, a decrease in Rrs is also observed.
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