Abstract
In a randomized double-blind placebo controlled study we examined the effects of dexamethasone (DEX) on inflammatory cells (ICs) in fluid from serial broncheo-alveolar lavage (BAL) from infants at high risk of developing neonatal chronic lung disease (CLD).
Infants <32 weeks gestation, <1250g birthweight, and still oxygen and ventilator dependent at 12 days were recruited. DEX was given from 14 days of age, at 0.6mg/ kg/day in a 2 week tapering course. 7 infants received placebo, and 7 DEX. 4 subsequent courses of DEX were studied. Mean IC concentrations and mean %neutrophils and % macrophages (as % of total ICs) were calculated for days -1 and 0, 1 and 3, and 5 and 7 for each baby; median % changes in the proportions of ICS were calculated for each group. Analysis of covariance was used to study the contribution of DEX to the changes.
The regression coefficients (RCs) for the changes in % neutrophils and %macrophages produced by DEX were -20.2 (95%CI -38.2 to -2.1) and 23.2 (95 % CI 6.6 to 39.7), respectively. There was a strong trend towards a fall in neutrophil concentration (RC -19.7 95 % CI -41.8 to 2.5).
The data suggest that DEX affects the IC population of BAL fluid in CLD by reducing neutrophils, and not macrophages as has been suggested in a previous study.
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Ashton, M., Hall, M. Dexamethasone Modulates the Pulmonary cellular inflammatory response in neonatal chronic lung disease. Pediatr Res 35, 284 (1994). https://doi.org/10.1203/00006450-199402000-00180
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DOI: https://doi.org/10.1203/00006450-199402000-00180