Linked Life Data

10393391

Source:http://linkedlifedata.com/resource/pubmed/id/10393391

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:dateCreated
1999-7-22
pubmed:abstractText
Chronic lung disease (CLD) remains a common problem in neonatal intensive care units. Corticosteroids are being used increasingly to prevent or treat CLD. Uncertainties remain including the timing, duration and route of administration, and ratio of benefits to costs. This paper reviews the outcome of 39 randomized clinical trials of postnatal corticosteroid treatment. Twenty-five trials studied systemic steroids at three different postnatal ages; early (<96 h), moderately early (7-14 days), and delayed (>3 weeks). Fourteen-trials studied inhaled steroids (early: <7 days; late: >14 days) and inhaled versus systemic steroids. Systemic steroids have short-term beneficial effects improving gas exchange and lung mechanics to facilitate earlier extubation when used at any postnatal age in infants who are ventilator dependent. Early and moderately early steroids also reduce the risk of CLD at both 28 days and 36 weeks. For moderately early steroid use, there is also a reduction in neonatal mortality with 1 extra survivor for approximately every 16 babies treated (95% confidence interval 9-55). Proven adverse effects are either gastro-intestinal (bleeding) or metabolic (hyperglycaemia and hypertension). Unproven but potential adverse effects include decreased brain and lung growth. Inhaled steroids have been studied less thoroughly. Some studies report improvement in gas exchange and lung mechanics, but long-term benefits are not apparent to date in the published material. Trials comparing inhaled and systemic steroids suggest a more rapid response with the latter, but no significant differences in the rate of CLD at either 28 days or 36 weeks were found. Further research is necessary to define the roles of systemic and inhaled steroids in the prevention and treatment of CLD and to allow comparison of benefits to costs.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jun
pubmed:issn
0006-3126
pubmed:author
pubmed:issnType
Print
pubmed:volume
76 Suppl 1
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
29-40
pubmed:dateRevised
2007-11-15
pubmed:meshHeading
pubmed:year
1999
pubmed:articleTitle
Clinical trials of postnatal corticosteroids: inhaled and systemic.
pubmed:affiliation
Department of Child Health, The Queen's University of Belfast and Regional Neonatal Unit, Royal Maternity Hospital, Belfast, Northern Ireland. h.halliday@queens-belfast.ac.uk
pubmed:publicationType
Journal Article, Comparative Study, Review