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A Randomized Trial of Inhaled Versus Intravenous Steroids in Ventilator-Dependent Preterm Infants

Journal of Perinatology volume 22, pages 196–203 (2002)Cite this article

Abstract

OBJECTIVE: Intravenous steroids improve the respiratory course in ventilator-dependent preterm infants but have adverse effects. We hypothesized that inhaled steroids would be as effective, but with less systemic effects.

STUDY DESIGN: We conducted a randomized, prospective trial comparing inhaled beclomethasone, either 400 or 800 μg/d, to intravenous dexamethasone in preterm infants dependent on conventional mechanical ventilation and supplemental oxygen at 2 weeks of age.

RESULTS: Seventy-eight infants were randomized. By day three of therapy, the intravenous steroid group had significantly decreased ventilator and oxygen requirements compared to either inhaled group. The inhaled 800-μg/d group trended toward more rapid decreases in ventilator and oxygen requirements than the 400-μg/d group. By day 14, all groups had similar reductions in ventilator and oxygen requirements. The incidence of adverse effects did not differ between groups.

CONCLUSIONS: In this small, randomized study, inhaled steroids conferred no advantages to intravenous steroids in the management of ventilator-dependent preterm infants.

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Authors and Affiliations

  1. Department of Pediatrics, Children's Hospital of Buffalo, Buffalo, NY, USA

    Sandra J Suchomski MD & James J Cummings MD

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  1. Sandra J Suchomski MD
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  2. James J Cummings MD
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Suchomski, S., Cummings, J. A Randomized Trial of Inhaled Versus Intravenous Steroids in Ventilator-Dependent Preterm Infants. J Perinatol 22, 196–203 (2002). https://doi.org/10.1038/sj.jp.7210705

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