Clinical study of Dexamethasone in different time for treatment and prevention of bronchopulmonary dysplasia

Objective To study the effect of using Dexamethasone in different time for treatment and prevention of bronchopulmonary dysplasia(BPD), in order to provide the clinical reference as to whether dexamethasone can be used to prevent and treat BPD. Methods A total of 135 very low birth weight infants hospitalized for 1 week who still survived on mechanical ventilation were studied.The total cases were divided into early Dexamethasone group and none Dexamethasone group.Whether early using dexamethasone could prevent BPD or not were observed.The BPD infants were divided into 3 groups, early Dexamethasone group, later Dexamethasone group and none Dexamethasone group.The effect of using Dexamethasone on BPD in different time were observed. Results (1)Among these 135 infants, there were 65 infants developing BPD.The incidence of BPD was 48.15%.There were no significant differences in the prevalence of BPD, the death rate and the disease index of BPD between the early Dexamethasone group and the none Dexamethasone group(all P>0.05).(2) There were no significant differences in mechanical ventilation time among the 3 BPD groups[(19.81±5.67) d vs(22.32±6.20) d,(21.46±7.02) d, P=0.405]. But the average time of inhaling oxygen and hospital stays of later Dexamethasone BPD group were shorter than early Dexamethasone BPD group and none Dexamethasone BPD group.The differences were significant[(37.27±10.14) d vs(45.96±9.91) d,(43.42±8.73) d, P=0.012;(64.11±8.14) d vs(76.13±7.57) d,(68.59±8.53) d, P=0.000].(3)The incidence of infection(90.90%, 100.00% vs 81.90%), hyperglycemia(27.27%, 30.43% vs 10.00%), hypertension(9.09%, 13.04% vs 0) and neonatal necrotizing enterocolitis(22.73%, 34.78% vs 15.00%) of all the infants who received Dexamethasone were higher than the infants who did not receive Dexamethasone.But the differences showed no significance(all P>0.05).(4) There were no significant differences among the 3 BPD groups in growth[weight:(9.16±1.53) kg vs(8.92±1.13) kg,(9.07±1.46) kg; height:(71.26±8.59) cm vs(69.54±9.32) cm,(70.32±9.07) cm] or been in hospital again because of pulmonary infection during one year(75.00% vs 65.00%, 72.22%)(all P>0.05). The differences of abnormal Chinese children development scale scores among the BPD groups(mental development index 0.05). Conclusions Early use of Dexamethasone has no effect to prevent BPD.Dexamethasone therapy on BPD should be used in the later stages, and small doses and short protocol are preferred. Key words: Dexamethasone; Bronchopulmonary dysplasia; Very low birth weight infant; Infant, premature