Between July 1/88 and March 1/92, 20 VLBW infants were found to be ventilator dependent (needed intermittient mandatory ventilation) at 28 days postnatal age. After parental consent, these infants were randomly assigned to receive either a 6-day course of intravenous dexamethasone 0.5 mg/kg/day for 3 days followed by 0.3 mg/kg/day for the final 3 days or to receive an equal volume of saline placebo. 11 infants received dexamethasone and 9 received saline. The groups were similar for use of antenatal steroids, sex, birth weight and the incidences of intrauterine growth retardation, birth depression and hyaline membrane disease. 5/9 infants assigned to the placebo group were born by Caeserean Section compared to 1/11 in the dexamethasone group(p=0.05). Results: There were 3 deaths prior to discharge from hospital, 2 in the dexamethasone group and 1 in the placebo group (p = NS). The remaining results are shown in the table below. Conclusion: Although a trend exists, the number enrolled in this trial was insufficient to detect a statistically significant difference in the number of days ventilated after dexamethasone/placebo treatment. The increased number of days of apneic spells is difficult to explain apart from a trend to earlier weaning from ventilation. The rate of retinopathy of prematurity needs to be carefully examined in larger trials of dexamethasone use in VLBW infants.

Table 1 No caption available.
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