Comparing low-dose (DART) and enhanced low-dose dexamethasone regimens in preterm infants with bronchopulmonary dysplasia

• Published in: Frontiers in pediatrics 2023-10, Vol.11, p.1261316-1261316
• Main Authors: Al-taweel, Heba Mohamed, Abdelhady, Ismail Sabry Ismail, Irfan, Nasreen, Khzzam, Fadi Al, Kamal, Abdullah, Thazhe, Sudheer Babu Kurunthattil, Bayoumi, Mohammad A. A., Gad, Ashraf
• Format: Article
• Language: English
• Subjects: bronchopulmonary dysplasia; chronic lung disease of prematurity; dexamethasone; extremely low birth weight; postnatal steroids; Respiratory distress syndrome
• ISSN: 2296-2360; 2296-2360
• DOI: 10.3389/fped.2023.1261316

IntroductionDetermining the optimal dexamethasone dosage for facilitating extubation in extremely low birth weight (ELBW) infants with bronchopulmonary dysplasia (BPD) remains uncertain. This study aims to compare the effectiveness of low-dose (DART) and enhanced low-dose dexamethasone regimens in achieving successful extubation in these infants.MethodsWe conducted a retrospective cohort study at the Women's Wellness and Research Center (WWRC) involving ELBW infants who received dexamethasone for BPD prevention or treatment, or for extubation between January 1st, 2015, and December 31st, 2019. Our goal was to assess successful extubation within various time points of treatement.ResultsA total of 77 patients, matched in gestational age and BW, were enrolled in the study, receiving a total of 121 dexamethasone courses. Low-dose dexamethasone courses were administered 75 times to 49 infants, while 46 courses of enhanced low-dose were given to 28 infants. Treatment commenced at 30.8 ± 3.4 weeks post-menstrual age, compared to 32.1 ± 2.5 weeks in the enhanced low-dose group (p = 0.014). The median (IQR) course duration was seven (3-10) days in the low-dose group, while it was 10 (8-14) days in the enhanced low-dose group (p