Journal of perinatology : official journal of the California Perinatal Association
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Randomized Controlled Trial Clinical Trial
Routine use of dexamethasone for the prevention of postextubation respiratory distress.
We evaluated the routine use of dexamethasone for the prevention of postextubation respiratory distress by entering 60 ventilated infants into a prospective, randomized, blinded study. Thirty minutes before extubation, 30 infants were given a single dose of intravenous dexamethasone (0.25 mg/kg), and 30 infants received saline placebo. Infants were intubated orotracheally for at least 48 hours following a single intubation and were maintained on low ventilator settings (F10(2) less than 0.35, intermittent mandatory ventilation [IMV] less than 6, positive end-expiratory pressure [PEEP] less than 4) at least 12 hours before extubation. ⋯ Stridor occurred in four infants in each group. No infant developed postextubation lobar atelectasis or required reintubation. We conclude that prophylactic administration of dexamethasone does not improve the immediate postextubation course of infants following a single intubation and that its routine use at the time of extubation is not indicated.
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Forty-one preterm infants weighing less than 1500 g and less than 32 weeks' gestation at birth had a Dubowitz neurological assessment performed at 40 weeks postconceptional age. The infants were classified into three groups. ⋯ The neuromotor performance of these three groups of infants was similar on all the Dubowitz assessment items at 40 weeks postconceptional age. Neuromotor development of very low birthweight infants with severe bronchopulmonary dysplasia appears to be no different from that of infants without bronchopulmonary dysplasia at 40 weeks postconceptional age utilizing the Dubowitz neurological assessment.