Effect of dexamethasone on pulmonary inflammation and pulmonary function of ventilator-dependent infants with bronchopulmonary dysplasia

Am Rev Respir Dis. 1991 May;143(5 Pt 1):1044-8. doi: 10.1164/ajrccm/143.5_Pt_1.1044.


Seventeen ventilator-dependent premature infants with bronchopulmonary dysplasia (BPD) were enrolled in a double-blind, placebo-controlled study to determine the effects of 3 days of intravenously administered dexamethasone (0.5 mg/kg/day) on pulmonary function, pulmonary inflammation, and the requirement for respiratory support (FIO2, ventilator peak pressure [PP], and respiratory rate [RR]). Assessment of pulmonary function included measurement of FVC, flow at 25% vital capacity (V25), and static compliance of the respiratory system (Crs), whereas pulmonary inflammation was assessed by the neutrophil count, ratio of elastase/2 x alpha-1-antitrypsin, and the concentrations of albumin and fibronectin in the tracheobronchial lavage (TBL) fluid. After 3 days of placebo treatment there were no significant changes in any of the measured parameters. In contrast, the dexamethasone-treated group demonstrated a significant decrease in respiratory support (FIO2: 50 versus 36%; PP: 21 versus 16 cm H2O; RR: 22 versus 14 breaths/min) and improved pulmonary function (Crs: 0.63 versus 0.85 ml/cm H2O/kg; V25: 23 versus 68 ml/s/kg). In addition, pulmonary inflammation was suppressed in the dexamethasone-treated group (neutrophils: 23 versus 11 x 10(4)/mg albumin: elastase/2 x alpha-1-antitrypsin: 0.24 versus 0.10; albumin: 7.1 versus 3.5 mg/dl; fibronectin: 33 versus 17 micrograms/mg albumin). We conclude that short-term treatment with dexamethasone improves pulmonary function and suppresses pulmonary inflammation as well as decreasing the respiratory support required by ventilator-dependent premature infants with BPD.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Albumins / analysis
  • Bronchoalveolar Lavage Fluid / chemistry
  • Bronchopulmonary Dysplasia / drug therapy*
  • Double-Blind Method
  • Fibronectins / analysis
  • Humans
  • Infant
  • Infant, Newborn
  • Pancreatic Elastase / analysis
  • Respiration, Artificial*
  • Respiratory Function Tests
  • Respiratory Mechanics / drug effects
  • alpha 1-Antitrypsin / analysis


  • Albumins
  • Fibronectins
  • alpha 1-Antitrypsin
  • Pancreatic Elastase