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Efficacy of late postnatal dexamethasone on weaning from invasive mechanical ventilation in extreme premature infants

Journal of Perinatology volume 41, pages 1951–1955 (2021)Cite this article

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Abstract

Objective

To evaluate the short-term respiratory effects of PND in a cohort of ventilator-dependent premature infants.

Study design

Clinical data from 106 infants 23–28 weeks gestation who received PND for weaning from MV during 2011–2017 were evaluated. PND was started at a dose of 0.1 mg/kg/d tapered over 5–7 d. Treatment success was defined as extubated and free from MV on d14 after start of treatment.

Result

Treatment was successful in 83 (78%) infants. Demographics and age of treatment did not differ between groups. In the failure group, a higher proportion were on HFOV and FiO2 ≥ 0.50 before treatment, compared to the successful group.

Conclusion

In most infants, PND resulted in successful weaning from MV. Reduced need for oxygen in infants not extubated may be beneficial, but it is unknown if this offsets the risks. The long-term effects PND in ventilator dependent infants need to be evaluated.

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Fig. 1: Days to extubation from start of PND.
Fig. 2: FiO2 requirement from start to d14 of PND.
Fig. 3: Change FiO2 requirement from start of PND to days 3, 7, and 14.

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Acknowledgements

The study received unrestricted support from the University of Miami Project NewBorn, a philanthropic organization that did not participate in any aspect of the research.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Children’s National Medical Center, Washington, DC, USA

    Waleed Kurtom

  2. Department of Pediatrics, Division of Neonatology, University of Miami School of Medicine, Miami, FL, USA

    Augusto Schmidt, Silvia Vanbuskirk, Alini Schott, Eduardo Bancalari & Nelson Claure

  3. Department of Pediatrics, Division of Neonatology, Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Deepak Jain

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  1. Waleed Kurtom
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  2. Augusto Schmidt
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Correspondence to Nelson Claure.

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Kurtom, W., Schmidt, A., Jain, D. et al. Efficacy of late postnatal dexamethasone on weaning from invasive mechanical ventilation in extreme premature infants. J Perinatol 41, 1951–1955 (2021). https://doi.org/10.1038/s41372-021-01108-4

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