Effect of five days of dexamethasone therapy on ventilator dependence and adrenocorticotropic hormone-stimulated cortisol concentrations

J Perinatol. Jan-Feb 1997;17(1):24-8.

Abstract

Objective: Our objective was to address the efficacy of 5 days of dexamethasone therapy in preterm infants dependent on ventilation and to measure adrenocorticotropic hormone-stimulated cortisol release after therapy.

Methods: This was a randomized, masked trial. Results were evaluated with Fisher's exact test and Wilcoxon test. Fifteen preterm infants in a newborn intensive care unit who were dependent on ventilation were enrolled at 8 to 24 days of age. Dexamethasone or normal saline solution was used for treatment. The main outcome measure was ventilator independence.

Results: Dexamethasone therapy correlated to successful extubation. Posttherapy peak adrenocorticotropic hormone-stimulated cortisol concentrations were lower in infants treated with dexamethasone than in infants treated with saline solution.

Conclusions: A 5-day course of dexamethasone may be adequate to achieve ventilator independence. The difference in peak cortisol concentrations may reflect suppression of the hypothalamic-pituitary-adrenal axis by dexamethasone or a higher peak cortisol response in the infants treated with saline solution who have higher ventilatory acuity after therapy.

Publication types

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

MeSH terms

  • Combined Modality Therapy
  • Cosyntropin*
  • Dexamethasone / administration & dosage
  • Dexamethasone / therapeutic use*
  • Drug Administration Schedule
  • Female
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use*
  • Humans
  • Hydrocortisone / blood*
  • Infant, Newborn
  • Infant, Premature, Diseases / therapy*
  • Intensive Care Units, Neonatal
  • Male
  • Respiration, Artificial*
  • Respiratory Distress Syndrome, Newborn / therapy*
  • Respiratory Function Tests
  • Treatment Outcome

Substances

  • Glucocorticoids
  • Cosyntropin
  • Dexamethasone
  • Hydrocortisone