Author/Editor		Babnik, J; Kornhauser-Cerar, L; Bregant, L; Štucin, I; Mole, H
Title		Zdravljenje dihalne stiske nedonošenčkov s kortikosteroidi: primerjava zgodnjega z odloženim zdravljenjem oz. sistemskega z inhalacijskim zdravljenjem
Translated title		Treatment of respiratory distress syndrome in preterm infants with corticosteroids: comparison between early and delayed, and between systemic and inhaled corticosteroids
Type		članek
Source		In: Gregorič A, editor. Nutritivna alergija. Farmakologija perinatalnega obdobja. Skrb za zdravje v prvem letu življenja. Zbornik predavanj 13. srečanje pediatrov v Mariboru z mednarodno udeležbo; 2003 apr 4-5; Maribor. Maribor: Splošna bolnišnica Maribor,
Publication year		2003
Volume		str. 86-92
Language		slo
Abstract		Aim of the study: Comparison of early steroid treatment of respiratory distress syndrome with delayed treatment and systemic with inhaled steroids, and assessment of risk for adverse outcome between these treatment regimens. Methods: Inclusion criteria: gestational age < 30 weeks, postnatal age < 72 hours, need for mechanical ventilation, Fi02 > 0.30, and parents' consent. Infants were randomly allocated in one of 4 treatmentgroups: 1. early (< 72 hours) dexamethasone (0.5 mg/kg/day in 2 doses for 12 days with reduction by half every 3 days until day 12), 2. delayed (> 15 days) selective dexamethasone if the infant still needed mechanical ventilation and > 30 ` of oxygen, 3. early (< 72 hours) budesonide (400 mg/kg twice daily for 12 days by metered dose inhaler and a spacing chamber only if the infant was intubated), 4. delayed (> 15 days) if the infant still needed mechanical ventilation and > 30` oxygen. Development of the infant was assessed using the Denver Developmental Screening Test, neurological, ophthalmological and otorinolaringological examinations. Results: Forty-six infants with mean birth weight 1104 g and mean gestational age 27,7 weeks were enrolled. There were no significant differences among groups in terms of birth weight, gestational age, gender, singleton birth, cesaren delivery and antenatal steroids. There were also no significant differences in duration of mechanical ventilation, supplementation of oxygen, hospitalisation, mortality and complications of steroid therapy (severe infection, hyperglicemia, hypertension, gastric bleeding). After pooling together the groups with early steroid treatment (dexamethasone or budesonide) and groups with systemic dexamethasone treatment (early or delayed) the risk of death or chronic lung disease at 36 postnatal days was lower than in the groups with delayed treatment [OR: 0.59 (0.33-1.05)], and lower in comparison with inhaled budesonide [OR: 0.76(0.69-2.58)]. (Abstract truncated at 2000 characters).
Descriptors		RESPIRATORY DISTRESS SYNDROME INFANT, PREMATURE, DISEASES DEXAMETHASONE INFANT, NEWBORN PULMONARY SURFACTANTS RESPIRATION, ARTIFICIAL