Abstract 122

Neonatal DX has been used for prevention/treatment of bronchopulmonary dysplasia (BPD). Prenatal DX decreases incidence of intracranial hemorrhage(ICH). We hypothesized that early DX (beginning day 1) compared to late DX(day 7 or later) shortens duration of mechanical ventilation and decreases the incidence of BPD and/or severe ICH.

In this study 28 infants with RDS treated with early DX (0.5mg/kg/d for 2 days) were compared to 28 similar infants treated with late DX (0.5mg/kg/d in decreasing doses for a mean of 23 days). These groups were similar in gestational age (mean 28.1 vs. 28.2 wk), birth weight (1049 vs. 1047 g), incidence of RDS, treatment with antenatal steroid and exogenous surfactant. Early DX decreased incidence of infections (p<0.06), days on inotropes(p<0.0001) and was not associated with significant adverse effects. The outcome was as follows: Table Early brief DX is associated with shorter duration of mechanical ventilation and improved outcome (survival w/o BPD or severe IVH/PVL). On the basis of this pilot study a randomised trial comparing efficacy and safety of early brief DX is indicated.

Table 1
Full size table