Impact of inhaled corticosteroids on the neurodevelopmental outcomes in chronically ventilated extremely low birth weight preterm infants

Despite the use of antenatal steroids, surfactants and protective ventilation, bronchopulmonary dysplasia (BPD) affects 10-89% of preterm infants. Since lung inflammation is central to the BPD pathogenesis, postnatal systemic corticosteroids could reduce the risk of BPD onset in preterm infants, but short and long-term adverse consequences have been underlined in literature after their use (i.e. hyperglycaemia, hypertension, hypertrophic cardiomyopathy, growth failure, gastrointestinal bleeding, cerebral palsy). To avoid their adverse effects, alternative therapeutic strategies such as postponing corticosteroid administration, lowering the cumulative dose, giving pulse rather than continuous doses, or individualizing the dose according to the respiratory condition of the infant have been proposed. Dexamethasone nonetheless remains the first line drug for newborns with severe pulmonary disease beyond the second to third week of life. Hydrocortisone administration in very preterm infants does not appear to be associated with any neurotoxic effects, even if its efficacy in the prevention and treatment of BPD has yet to be clearly demonstrated. Alternative methods of corticosteroids administration seem promising. A positive effect on BPD prevention occurs when budesonide is nebulized and intratracheally instilled with surfactant, but more data are required to establish safety and efficacy in preterm newborns. Additional studies are still needed before the chronic lung disease issue and its related challenges can be solved.

show abstract

Brain Damage in the Preterm Infant: Clinical Aspects and Recent Progress in the Prevention and Treatment

Xie

Yang

Yuan

2023

CNSNDDT

View full text Add to dashboard Cite

Although the prevalence of brain injury and related neurodevelopmental disabilities resulting from preterm birth are major public health concerns, there are no definite neuroprotective strategies to prevent or reduce brain injury. The pattern of brain injury seen in preterm infants has evolved into more subtle lesions that are still essential to diagnose regarding neurodevelopmental outcomes. There is no specific effective method for the treatment of premature infant brain injury and the focus of clinical treatment is still on prevention. Prevention of this injury requires insight into the pathogenesis, but many gaps exist in our understanding of how neonatal treatment procedures and medications impact cerebral hemodynamics and preterm brain injury. Many studies provide evidence about the prevention of premature infant brain injury, which is related to some drugs (such as erythropoietin, melatonin, mesenchymal stem cells and the like), however, there are still some controversies about the quality of research and the effectiveness of therapy. Conclusion: The main aims of this review are to recapitulate the results of preclinical studies and provide an update on the latest developments around etiological pathways, prevention, and treatment.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Impact of inhaled corticosteroids on the neurodevelopmental outcomes in chronically ventilated extremely low birth weight preterm infants

Cited by 3 publications

References 26 publications

A 20-cm cut umbilical cord milking may not benefit the preterm infants < 30 week's gestation: A randomized clinical trial

A 20-cm cut umbilical cord milking may not benefit the preterm infants < 30 week's gestation: A randomized clinical trial

Current Concepts of Corticosteroids Use for the Prevention of Bronchopulmonary Dysplasia

Brain Damage in the Preterm Infant: Clinical Aspects and Recent Progress in the Prevention and Treatment

Contact Info

Product

Resources

About