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

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

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

a Division of Developmental and Behavior Pediatrics, College of Medicine, China Medical University, Taichung, Taiwan

b Division of Neonatology, College of Medicine, China Medical University, Taichung, Taiwan

c Division of Pediatric Neurology, College of Medicine, China Medical University, Taichung, Taiwan

d Department of Biotechnology, Asian University, Wufeng, Taiwan

e Department of Pediatrics, John H. Stroger Jr Hospital of Cook County, Chicago, IL Supported in part by the National Science Council Taiwan (NSC96-2314-B-039-008-MY2).The authors have no conflicts of interest

Reprint requests Dr Tsu F. Yeh, Department of Pediatrics, College of Medicine, China Medical University, 91 Hsieh Shi Road, Taichung, Taiwan.

Supported in part by the National Science Council Taiwan (NSC96-2314-B-039-008-MY2). The authors declare no conflicts of interest.

PII: S0022-3476(09)01099-3

doi:10.1016/j.jpeds.2009.10.049