A Follow-up Study of Preterm Infants Given Budesonide Using Surfactant as a Vehicle to Prevent Chronic Lung Disease in Preterm Infants

Kuo, Huang T.; Lin, Hong C.; Tsai, Chang H.; Chouc, I.C.; Yeh, Tsu F.

doi:10.1016/j.jpeds.2009.10.049

« Previous Next »The Journal of Pediatrics
Volume 156, Issue 4 , Pages 537-541, April 2010

A Follow-up Study of Preterm Infants Given Budesonide Using Surfactant as a Vehicle to Prevent Chronic Lung Disease in Preterm Infants

Huang T. Kuo, MD, PhD
- Division of Developmental and Behavior Pediatrics, College of Medicine, China Medical University, Taichung, Taiwan
- Division of Pediatric Neurology, College of Medicine, China Medical University, Taichung, Taiwan
Hong C. Lin, MD
- Division of Neonatology, College of Medicine, China Medical University, Taichung, Taiwan
Chang H. Tsai, MD, PhD
- Division of Pediatric Neurology, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Biotechnology, Asian University, Wufeng, Taiwan
I.C. Chouc
- Division of Pediatric Neurology, College of Medicine, China Medical University, Taichung, Taiwan
Tsu F. Yeh, MD, PhD
- Division of Neonatology, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Pediatrics, John H. Stroger Jr Hospital of Cook County, Chicago, IL
- Reprint requests Dr Tsu F. Yeh, Department of Pediatrics, College of Medicine, China Medical University, 91 Hsieh Shi Road, Taichung, Taiwan.

Received 7 May 2009; received in revised form 11 September 2009; accepted 29 October 2009. published online 08 February 2010.

Objective

Our study of early intratracheal instillation of budesonide using surfactant as vehicle showed a significant decrease in death or chronic lung disease (CLD) in preterm infants with severe respiratory distress syndrome (RDS). We now report the long-term outcome at about 2 to 3 years of age.

Study design

Of the 75 potential survivors, 67 (90%) were studied (35 budesonide-treated, 32 control). All infants had birth weight <1500 g and had severe RDS requiring intermittent mechanical ventilation shortly after birth. The treated group received a mixture of budesonide and surfactant every 8 hours. The control group received only surfactant.

Results

The physical growth and the neurological examinations were comparable between the groups at follow-up. Infants in the group treated with budesonide tended to have higher PDI and MDI scores than infants in the control group (79 ± 20 vs 74 ± 18 and 80 ± 19 vs 75 ± 20), but these differences were not statistically significant. The incidence of neurodevelopmental impairment was 11 (31%) in the treated group and 13 (40%) in the control group (P = .367).

Conclusions

Early intratracheal instillation of budesonide using surfactant as a vehicle significantly improved pulmonary outcome without causing long-term adverse effects.

BSID-II, Bayley Scale of Infant Development-II, CLD, Chronic lung disease, IVH, Intraventricular hemorrhage, MDI, Mental Development Index, PDA, Patent ductus arteriosus, PDI, Psychomotor Development Index, RDS, Respiratory distress syndrome