Prenatal and Postnatal Steroids and Pulmonary Outcomes

Jobe, Alan H.

doi:10.1016/b978-0-323-54605-8.00020-9

Cited by 3 publications

(2 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 3 ] However, the effect of antenatal steroid administration on reducing the frequency of BPD has not been fully determined. [ 25 ] To reduce the frequency of BPD and intubation, the use of glucocorticoids increased gradually in the postnatal period, and the frequency of steroid use increased to 25% in babies with a gestational age of <28 weeks in the 1990s. As a result of the data obtained in this process, the negative effects of steroids on neuromotor development and growth values were observed.…”

Section: Effect Of Glucocorticoids On the Development Of Bpdmentioning

confidence: 99%

Role of Postnatal Corticosteroids in the Treatment or Prevention of Bronchopulmonary Dysplasia

Bülbül¹

2023

Sisli Etfal

View full text Add to dashboard Cite

As the frequency of viable low birth weight preterm babies increases, bronchopulmonary dysplasia (BPD), one of the most important morbidities in these babies, also increases. Using postnatal steroids to reduce the development of BPD has not been fully enlightened. Besides all prevention strategies for reducing the development of BPD, it is known that steroid therapy used in the 1 st week of life could induce negative neuromotor development according to current data. It may be recommended to administer low-dose dexamethasone between 8 and 49 days in infants dependent on mechanical ventilators in the postnatal period. It is seen that the use of hydrocortisone in the early period does not cause negative neuromotor development, but it cannot prevent the development of BPD as much as dexamethasone. All intensive care units must have their steroid protocol for BPD and use steroids in cases when the BPD development scale score is >60–65% and should have a goal of trying to keep the cumulative dose at the lowest level.

show abstract

Section: Effect Of Glucocorticoids On the Development Of Bpdmentioning

confidence: 99%

Role of Postnatal Corticosteroids in the Treatment or Prevention of Bronchopulmonary Dysplasia

Bülbül¹

2023

Sisli Etfal

View full text Add to dashboard Cite

show abstract

“…Despite decreasing the rate of RDS, however, a reduction in BPD has not been observed. 32 Administration of systemic steroids after birth has shown benefit in facilitating extubation and reducing BPD, though systemic steroid administration is not without risk and includes hyperglycemia, hypertension, and spontaneous intestinal perforation (often with concomitant use of nonsteroidal anti-inflammatory agents). Dexamethasone, a potent steroidal agent, has historically been used in relatively high doses early in a premature infant's postnatal course to provide pulmonary benefit (up to 8 mg/kg over 42 days); 33 while acute improvement in gas exchange and lung mechanics has been observed, follow-up studies revealed an increase in adverse neurodevelopmental outcomes, especially cerebral palsy.…”

Section: Corticosteroidsmentioning

confidence: 99%

New Pharmacologic Approaches to Bronchopulmonary Dysplasia

Roberts¹,

Stepanovich²,

Bhatt‐Mehta³

et al. 2021

JEP

View full text Add to dashboard Cite

Bronchopulmonary Dysplasia is the most common long-term respiratory morbidity of preterm infants, with the risk of development proportional to the degree of prematurity. While its pathophysiologic and histologic features have changed over time as neonatal demographics and respiratory therapies have evolved, it is now thought to be characterized by impaired distal lung growth and abnormal pulmonary microvascular development. Though the exact sequence of events leading to the development of BPD has not been fully elucidated and likely varies among patients, it is thought to result from inflammatory and mechanical/oxidative injury from chronic ventilatory support in fragile, premature lungs susceptible to injury from surfactant deficiency, structural abnormalities, inadequate antioxidant defenses, and a chest wall that is more compliant than the lung. In addition, non-pulmonary issues may adversely affect lung development, including systemic infections and insufficient nutrition. Once BPD has developed, its management focuses on providing adequate gas exchange while promoting optimal lung growth. Pharmacologic strategies to ameliorate or prevent BPD continue to be investigated. A variety of agents, to be reviewed henceforth, have been developed or re-purposed to target different points in the pathways that lead to BPD, including anti-inflammatories, diuretics, steroids, pulmonary vasodilators, antioxidants, and a number of molecules involved in the cell signaling cascade thought to be involved in the pathogenesis of BPD.

show abstract