The objective of the study was to compare the effect of two different dexamethasone regimens on respiratory outcomes of ventilator-dependent preterm infants.
Retrospective study of ventilated preterm infants <29 weeks gestational age treated with either 7-day or 10-day dexamethasone course. Primary outcome was days to successful extubation. Other outcomes included rate of successful extubation and need for repeat steroid therapy.
Fifty-nine infants were identified; 32 (54%) received 7 days of dexamethasone and 27 (46%) received 10 days of dexamethasone. Both groups had comparable baseline demographics and clinical characteristics. Mean time to successful extubation was similar between the two groups (5.1±2.7 days in 7-day group and 6.0±3.7 days in 10-day group, P=0.42). Successful extubation by end of treatment (56% versus 67%, P=0.44) and need for repeat steroid therapy (47% versus 33%, P=0.43) were also similar.
7-day and 10-day course of dexamethasone have comparable efficacy in facilitating extubation of ventilator-dependent preterm infants.
Subscribe to Journal
Get full journal access for 1 year
only $20.67 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
Walsh MC, Morris BH, Wrage LA, Vohr BR, Poole WK, Tyson JE et al. Extremely low birthweight neonates with protracted ventilation: mortality and 18-month neurodevelopmental outcomes. J Pediatr 2005; 146 (6): 798–804.
Cummings JJ, D'Eugenio DB, Gross SJ . A controlled trial of dexamethasone in preterm infants at high risk for bronchopulmonary dysplasia. N Engl J Med 1989; 320 (23): 1505–1510.
Ohlsson A, Calvert SA, Hosking M, Shennan AT . Randomized controlled trial of dexamethasone treatment in very-low-birth-weight infants with ventilator-dependent chronic lung disease. Acta Paediatr 1992; 81 (10): 751–756.
Durand M, Mendoza ME, Tantivit P, Kugelman A, McEvoy C . A randomized trial of moderately early low-dose dexamethasone therapy in very low birth weight infants: dynamic pulmonary mechanics, oxygenation, and ventilation. Pediatrics 2002; 109 (2): 262–268.
Kothadia JM, O'Shea TM, Roberts D, Auringer ST, Weaver RG 3rd, Dillard RG . Randomized placebo-controlled trial of a 42-day tapering course of dexamethasone to reduce the duration of ventilator dependency in very low birth weight infants. Pediatrics 1999; 104 (1 Pt 1): 22–27.
Barrington KJ . The adverse neuro-developmental effects of postnatal steroids in the preterm infant: a systematic review of RCTs. BMC Pediatr 2001; 1: 1.
Halliday HL, Ehrenkranz RA, Doyle LW . Early (< 8 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants. Cochrane Database Syst Rev 2009; (1): CD001146.
Shinwell ES, Karplus M, Reich D, Weintraub Z, Blazer S, Bader D et al. Early postnatal dexamethasone treatment and increased incidence of cerebral palsy. Arch Dis Child Fetal Neonatal Ed 2000; 83 (3): F177–F181.
O'Shea TM, Kothadia JM, Klinepeter KL, Goldstein DJ, Jackson BG, Weaver RG 3rd et al. Randomized placebo-controlled trial of a 42-day tapering course of dexamethasone to reduce the duration of ventilator dependency in very low birth weight infants: outcome of study participants at 1-year adjusted age. Pediatrics 1999; 104 (1 Pt 1): 15–21.
Bhatt AJ, Feng Y, Wang J, Famuyide M, Hersey K . Dexamethasone induces apoptosis of progenitor cells in the subventricular zone and dentate gyrus of developing rat brain. J Neurosci Res 2013; 91 (9): 1191–1202.
Feng Y, Rhodes PG, Liu H, Bhatt AJ . Dexamethasone induces neurodegeneration but also up-regulates vascular endothelial growth factor A in neonatal rat brains. Neuroscience 2009; 158 (2): 823–832.
Irakam A, Miskolci V, Vancurova I, Davidson D . Dose-related inhibition of proinflammatory cytokine release from neutrophils of the newborn by dexamethasone, betamethasone, and hydrocortisone. Biol Neonate 2002; 82 (2): 89–95.
Doyle LW, Davis PG, Morley CJ, McPhee A, Carlin JB, Investigators DS . Low-dose dexamethasone facilitates extubation among chronically ventilator-dependent infants: a multicenter, international, randomized, controlled trial. Pediatrics 2006; 117 (1): 75–83.
Walther FJ, Findlay RD, Durand M . Adrenal suppression and extubation rate after moderately early low-dose dexamethasone therapy in very preterm infants. Early Hum Dev 2003; 74 (1): 37–45.
Watterberg KL American Academy of Pediatrics. Committee on F, Newborn. Policy statement—postnatal corticosteroids to prevent or treat bronchopulmonary dysplasia. Pediatrics 2010; 126 (4): 800–808.
Bloomfield FH, Knight DB, Harding JE . Side effects of 2 different dexamethasone courses for preterm infants at risk of chronic lung disease: a randomized trial. J Pediatr 1998; 133 (3): 395–400.
Odd DE, Armstrong DL, Teele RL, Kuschel CA, Harding JE . A randomized trial of two dexamethasone regimens to reduce side-effects in infants treated for chronic lung disease of prematurity. J Paediatr Child Health 2004; 40 (5-6): 282–289.
Jones BO, Davies MW . Total steroid dose given to ventilated newborn infants with chronic lung disease. J Paediatr Child Health 2007; 43 (1-2): 40–43.
Malloy C, Hilal K, Rizvi Z, Weiss M, Muraskas J . A prospective, randomized, double-masked trial comparing low dose to conventional dose dexamethasone in neonatal chronic lung disease. Internet J Pediatr Neonatol 2005; 5: 1.
Rozycki HJ, Byron PR, Elliott GR, Carroll T, Gutcher GR . Randomized controlled trial of three different doses of aerosol beclomethasone versus systemic dexamethasone to promote extubation in ventilated premature infants. Pediatr Pulmonol 2003; 35 (5): 375–383.
Tanney K, Davis J, Halliday HL, Sweet DG . Extremely low-dose dexamethasone to facilitate extubation in mechanically ventilated preterm babies. Neonatology 2011; 100 (3): 285–289.
Yates HL, Newell SJ . Minidex: very low dose dexamethasone (0.05 mg/kg/day) in chronic lung disease. Arch Dis Child Fetal Neonatal Ed 2011; 96 (3): F190–F194.
Yates HL, Johnson K, Turner MA . The Minidex trial: does very low dose dexamethasone improve lung function in preterm infants? Infant 2016; 12 (2): 49–51.
Jobe AH . Postnatal corticosteroids for bronchopulmonary dysplasia. Clin Perinatol 2009; 36 (1): 177–188.
Wilkinson GR . Drug metabolism and variability among patients in drug response. N Engl J Med 2005; 352 (21): 2211–2221.
We would like to thank the Medical Writing Center at Children’s Mercy Kansas City for their assistance in proofreading and editing this manuscript.
The authors declare no conflict of interest.
About this article
Cite this article
Cuna, A., Govindarajan, S., Oschman, A. et al. A comparison of 7-day versus 10-day course of low-dose dexamethasone for chronically ventilated preterm infants. J Perinatol 37, 301–305 (2017) doi:10.1038/jp.2016.215
Early Human Development (2019)
Usefulness of an Online Risk Estimator for Bronchopulmonary Dysplasia in Predicting Corticosteroid Treatment in Infants Born Preterm
The Journal of Pediatrics (2018)
Timing of postnatal corticosteroid treatment for bronchopulmonary dysplasia and its effect on outcomes
Pediatric Pulmonology (2018)