Early inhaled budesonide in extremely preterm infants decreases long‐term respiratory morbidity
| Autor: | Daniela Markova, Richard Plavka, Jana Tukova, Blanka Zlatohlavkova, Jan Smisek |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Lung Diseases
Male Pulmonary and Respiratory Medicine Budesonide Spirometry medicine.medical_specialty Vital capacity Placebo Pulmonary function testing Cohort Studies 03 medical and health sciences FEV1/FVC ratio 0302 clinical medicine 030225 pediatrics Internal medicine Administration Inhalation medicine Humans Glucocorticoids Lung medicine.diagnostic_test business.industry Respiratory disease Infant Newborn respiratory system medicine.disease Bronchodilator Agents 030228 respiratory system Bronchopulmonary dysplasia Infant Extremely Premature Pediatrics Perinatology and Child Health Female business medicine.drug |
| Zdroj: | Pediatric Pulmonology. 55:1124-1130 |
| ISSN: | 1099-0496 8755-6863 |
| DOI: | 10.1002/ppul.24704 |
| Popis: | Background There is no strict correlation between early bronchopulmonary dysplasia and long-term respiratory disease. Early inhaled corticosteroids seem to reduce the incidence of bronchopulmonary dysplasia, but the long-term outcome remains unknown. Research question The aim of this study was to evaluate the effect of early inhaled corticosteroids on chronic respiratory morbidity. Methods Fifty-nine survivors from the Prague cohort included in Neonatal European Study of Inhaled Steroids underwent further follow-up comprising of respiratory morbidity monitoring during the first 2 years of life followed by objective lung function testing performed at the age of 5.9 years (range 5-7 years). Both outcomes were pursued and finalized before the unblinding of budesonide subgroups. Results Fifty randomized (budesonide vs placebo group, 56% vs 44%) survivors were included in the study. Spirometry was successfully performed in 48 children. No statistically significant differences were found in the lung function test (forced expiratory flow [FEF] - FEF75 , FEF50, FEF25 , and FEF25-75; FEV1 , forced vital capacity [FVC], FEV1 /FVC) although mild trend to the improvement of expiratory flow pattern was observed in the budesonide group (median z-score of FEV1 /FVC -0.376 vs -0.983, P = .13; median z-score of FEF25-75 -1.004 vs -1.458, P = .13; median z-score of FEF75 -0.527 vs -0.996, P = .17). Children assigned to budesonide had a significantly lower rate of symptoms of chronic lung disease (34.6% vs 68.2%; P = .04) than children assigned to placebo. Interpretation Our study suggests that early inhaled budesonide was associated with the trend to the improvement of functional lung parameters and with a lower rate of symptoms of chronic lung disease within the first 2 years of life. |
| Databáze: | OpenAIRE |
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