Cardiorespiratory adaptation to low‐dose dexamethasone for lung disease in extremely preterm infants: A prospective echocardiographic study

Sehgal, Arvind; Nold, Marcel F.; Roberts, Calum T.; Menahem, Samuel

doi:10.1113/jp282973

Cited by 3 publications

(3 citation statements)

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“…Our results do not show any significant change in the septal and LV dimensions, possibly because our cumulative dose of dexamethasone was substantially lower than the doses used in these studies. Similar results were reported by Sehgal et al, who used a cumulative dexamethasone dose of 0.89 mg/kg [22], which is a very similar dose range to that in our study.…”

Section: Discussionsupporting

confidence: 92%

“…Interestingly, an improvement in RV performance was consistently demonstrated at all study time periods. Sehgal et al also reported an improvement in RV systolic performance [22]. Such improvement could be due to a concurrent improvement in pulmonary compliance and a reduction in inflation pressures.…”

Section: Discussionmentioning

confidence: 89%

“…Specific PDA-related echocardiographic parameters were not further investigated in our present study. Sehgal et al showed significant ductal constriction post dexamethasone use, along with improvements in metrics of pulmonary over circulation [22]. There have been some other studies that have reported ductal closure with steroids [25,26].…”

Section: Discussionmentioning

confidence: 97%

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Improved Cardiac Performance with Dexamethasone Therapy in Premature Neonates: Novel Insights Using Serial Echocardiographic Assessments

Ladele,

Saker,

Altamimi

et al. 2023

Applied Sciences

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(1) Background: dexamethasone is used for the prevention and treatment of chronic lung disease (CLD) in premature neonates, and its impact on cardiac performance and pulmonary vascular resistance has not been well studied. (2) Methods: eligible neonates of <30 weeks gestational age (GA) had echocardiograms performed on them at three time points—before the initiation of dexamethasone (Echo-1), 24–48 h post the completion of dexamethasone therapy (Echo-2), and 7–14 days after course completion (Echo-3). (3) Results: 28 neonates with a 25.2 week mean GA and 652.9 g birthweight were included. The mean cumulative dose of dexamethasone was 0.98 mg/kg, given over 8–10 days. Echo-1 and Echo-2 showed a significant improvement in the right ventricular fractional area change (RV FAC 44.88 vs. 49.71, p = 0.025), tricuspid annular plane systolic excursion (TAPSE 0.65 cm vs. 0.70 cm, p = 0.013), and RV S’ (7.18 vs. 8.56, p = 0.05). The left ventricular (LV) ejection fraction was similar but with a significant increase in the LV S’ (4.77 vs. 6.01, p = 0.006). A longitudinal analysis at three time points showed a significant increase in RV FAC (0.02 units 95% CI (0.00–0.04), p = 0.037), TAPSE (0.09 units 95% CI (0.06–0.13), p < 0.001), RV S’ (0.97 units (95% CI = 0.11–1.84), p = 0.028), a reduction in the eccentricity index (0.07 units 95% CI (−0.14–−0.01), p = 0.030), and an increase in the LV S’ (0.56 units (95% CI = 0.18–0.94)). (4) Conclusion: The use of postnatal dexamethasone for the prevention/treatment of CLD in premature neonates resulted in an expected improvement in respiratory status along with a significant improvement in the echocardiographic measures of biventricular heart performance.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 89%