Hydrocortisone Seems Safe in Infantile Bronchopulmonary Dysplasia

June 05, 2013

By David Douglas

NEW YORK (Reuters Health) Jun 05 - In preterm infants with bronchopulmonary dysplasia, hydrocortisone does not seem to have adverse effects, according to European researchers.

"Hydrocortisone might be a safer alternative for treatment of chronic lung disease in preterm infants compared to dexamethasone, because it seems to be as successful for extubation and appears to have less adverse neurological impact on the immature brain (as shown by less effects of brain volumes and neurodevelopmental outcomes)," Dr. Manon J. N. L. Benders told Reuters Health by email.

In a May 23 online paper in The Journal of Pediatrics, Dr. Benders of University Medical Center Utrecht, The Netherlands, and colleagues note that although "the short-term effects of dexamethasone prescription on pulmonary function are satisfactory, effects on long-term neurodevelopmental outcome are not."

In their study, the team retrospectively compared 73 infants who received hydrocortisone therapy and had MRI brain scans at term equivalent age, and a matched set of 73 controls. The mean gestational age was 26.7 weeks; the mean birth weight was 906 g.

Hydrocortisone was not associated with a reduction in total brain tissue volume or cerebellar volume. No differences were found between treated infants and controls in total brain tissue or cerebellar volumes.

The researchers say the results are consistent with their previous findings.

"Ours and other studies on hydrocortisone should encourage neonatologists to consider informed parental consent prior to administration of corticosteroids for chronic lung disease in favor of hydrocortisone," Dr. Benders said.

"Meantime," she concluded, "a more definitive answer to the effect of hydrocortisone has to be given in a randomized controlled trial with long-term neurodevelopmental outcome, where possible confounders can be eliminated."

SOURCE: http://bit.ly/11lDeRg

J Pediatr 2013.

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