Total steroid dose given to ventilated newborn infants with chronic lung disease

Abstract

There are currently two dexamethasone regimes used in our nursery. We aimed to retrospectively compare the cumulative dose of dexamethasone that infants on each regime received and the requirement for further courses. Infants receiving dexamethasone between 1 January 2000 and 31 December 2004, with a gestational age of <30 weeks or a birthweight of <1000 g, were identified and then a chart review of these infants was undertaken. Demographic data were obtained and compared as was the total dose of dexamethasone and number of courses that each infant received. Some clinical outcome measurements were also obtained. A total of 119 infants were identified. The total dexamethasone dose received was 1.92 mg/kg less for infants commencing on the 2-week course compared with the 6-week course (difference between medians, Mann-Whitney test, P=0.005). Infants having the 2-week course had 17 days less steroid treatment (difference between medians, Mann-Whitney test, P=0.0001). Seventeen (46%) subjects who started on a 2-week course of steroids and 18 (22%) who started on a 6-week course required at least one further course of steroids (Fisher's exact test, P=0.01). There were no significant differences in the short-term outcome measures of neonatal chronic lung disease. Infants who received the 2-week course of dexamethasone had a 27% reduction in total steroid dose compared with infants receiving a 6-week course with similar short-term outcomes. However, our study was limited by its retrospective nature and possible confounding factors.