Comparison of Intravenous Dexamethasone and Budesonide Nebulizer in the Treatment of Infantile Respiratory Distress Syndrome; A Randomized Clinical Trial

Abstract

Background: Respiratory distress syndrome (RDS) is one of the most common causes of mortality in preterm infants. Despite appropriate results of corticosteroids prescription for preventing RDS, early use of these medications after birth has raised concerns about short and long-term complications. Inhaler corticosteroids have lower systemic absorption and have been considered to decrease short and long term complications of systemic corticosteroids to minimum. Objectives: In this randomized clinical trial we aimed to assess effectiveness of intravenous dexamethasone and budesonide nebulizer in treatment of infantile respiratory distress syndrome. Methods: In this randomized clinical trial preterm infants with confirmed diagnosis of RDSwere randomly allocated to two groups; the first group received intravenous Dexamethasone (0.15 mg/kg every 12 hours) and the second group received Budesonide nebulizer (200 μg/ day) through jet nebulizer. Treatment duration, complicationsand received doses as well as response to treatment and mortality rates were recorded in a checklist. Results: Finally 60 infants (35 female and 25 male) in Budesonide and Dexamethasone groups underwent analysis. Mean arterial oxygen saturation was 88.60±3.21 % in Budesonide and 88.13±3.73% in Dexamethasone group before intervention (p=0.606). In the fifth day of intervention it was 93.80±2.14% in Budesonide and 93.25±3.76 in Dexamethasone group (p=0.441). Prior to intervention, Budesonide group had a mean respiratory rate (RR) of 71.50±12.33 and it was 67.17±12.84 in Dexamethasone group (p=0.188). In the fifth day of intervention, infants had a mean RR of 45.66±8.87 in Budesonide and 48.21±10.11 in Dexamethasone group (p= 0.179). Mean hospitalization duration was 16.36±11.32 days in Dexamethasone and 17.40±14.39 in Budesonide group (p=0.758). Conclusion: We concluded that there is no significant difference between intravenous Dexamethasone and Budesonide nebulizer for treatment of infantile RDS.