An increasing proportion of VLBW infants developing chronic lung disease have little initial respiratory distress. In a pilot study, we documented a one week weaning course of DEX given to extubated, oxygen dependent VLBW infants to significantly increase FRC and CRS (Am Rev Respir Crit Care Med 1997;155:A235). We now report the results of a randomized, placebo controlled trial of DEX (0.5 mg/kg/day × 3 days; 0.25 mg/kg/day × 3 days; 0.1 mg/kg/day × 1 day) in VLBW infants who are extubated but oxygen dependent at greater than 5 days of age. Nine infants received DEX (mean BW=1164g; GA= 27.9 wks; FiO2=30%; age=19.9 days), while ten infants served as controls (mean BW= 1070g; GA= 28.2 wks; FiO2=31%; age=16.0 days). FRC was measured with the nitrogen washout technique. A minimum of two measurements were performed with the neonate supine and quiet. A study was acceptable if the measurements had a coefficient of variation <10%. CRS was measured using the single breath occlusion technique (SensorMedics 2600).Significantly more infants in the DEX group weaned to room air by the end of therapy. Our preliminary results demonstrate a one week course of DEX given to extubated but oxygen dependent VLBW infants significantly increases FRC (78%) and CRS(40%). We speculate that DEX may decrease the development of chronic lung disease in oxygen dependent VLBW infants. Table

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