Comparing the Effect of Inhaler N-Acetyl Cysteine and Intravenous Dexamethasone on Respiratory Distress Syndrome in Premature Infants: A Randomized Clinical Trial

Abstract

Background: Respiratory distress syndrome (RDS) is one of the most common respiratory disorders among premature infants. Despite recent developments in the application of corticosteroids for preventing RDS, their superiority and possible complications have remained controversial. Methods: In this randomized clinical trial, infants with confirmed diagnosis of RDS were randomly allocated into 2 groups. The first group underwent treatment with intravenous dexamethasone (0.15 mg/kg every 12 hours), and the second group received NAC nebulizer (400 mg every 8 hours) as well as intravenous dexamethasone for 3 to 5 days. Treatment duration, disease and drug complications, number of received doses as well as response to treatment (based on oxygen dependency and need for reintubation), and mortality rates were recorded in a checklist. Results: Finally we evaluated 60 (33 males and 27 females) infants in 2 dexamethasone and N-Acetyl Cysteine groups. Mean arterial oxygen saturation was 88.70% ± 4.31% in NAC and 87.90% ± 5.96% in dexamethasone group before intervention (P = 0.553). In the fifth day of the intervention, the mean arterial oxygen saturation was 93.80 ± 3.86 in NAC and 93.4% ± 3.79% in dexamethasone group (P = 0.321). Prior to the intervention, infants in NAC group had a mean respiratory rate (RR) of 66.33 ± 8.33, and this was 65 ± 12.66 in infants in dexamethasone group (P = 0.656). In the fifth day of intervention, infants had a mean RR of 46.67 ± 9.21 in NAC and 49 ± 12.66 in dexamethasone groups (P = 0.454). Conclusions: No significant difference was obtained between intravenous dexamethasone alone and intravenous dexamethasone with N-Acetyl cysteine nebulizer in the treatment of infantile respiratory distress syndrome. However, a significant response to treatment was observed in both groups.