Abstract 79
Background: CLD continues to be a major cause of morbidity and long-term impairment of lung function. Treatment with systemic steroids may improve short-term pulmonary outcome but concerns regarding long-term side effects limit their use. Aim: to determine if inhalation steroids can rapidly normalize pulmonary function in infants with CLD stage II-III.Subjects: 19 spontaneously breathing VLBW infants, mean GA 26 weeks (23,2-31,5), mean BW 806 g (426-1188) with oxygen dependency (OD), tachypnea (T), increased work of breathing (IWB) and slow clinical improvement. Serial Measurements of compliance (Crs), resistance(Rrs), repiratory rate (RR), ventilation (VE), peak inspir/expir flow rates (PIFR, PEFR) were performed before, during and after the therapy.Results: OD and IWB subsided within 5 weeks after the initiation of steroid treatment (IST). There was accompanied by a significant improvement in Crs(p=0,02), Rrs(p=0,01) and VE(p=0,01). Significant improvement in RR(p=0,01) and PIFR/PEFR(p=0,00) >70/60% respectively was observed after 11 weeks after IST. All variables were within normal range after 15 weeks in 14 of 19 infants. No clinical relapses after discontinuation of therapy and no monitored side effects were observed (oropharyngeal candidiasis, bronchospasm). Conclusion: Inhalation steroid therapy is feasible in VLBW infants and is associated with a rapid a sustained improvement in clinical symptoms and pulmonary function. These results supports the need for a large scale randomized trial.
