Efficacy of budesonide for prevention of bronchopulmonary dysplasia in premature newborns with different gestation age

Abstract

Prematurely born children with severe respiratory distress-syndrome are at risk of bronchopulmonary dysplasia (BPD) development. Treatment of BPD is extremely difficult and sometimes non-effective; therefore, prevention of this disease is an actual problem. Efficacy of budesonide for BPD prevention in comparison to children not treated with this drug has been proven in recent studies but its action differed according to the gestation age and body weight. The present study was aimed to compare efficacy of inhaled budesonide in newborns with various gestation ages. To evaluate the efficacy of the therapy, all the children involved in the study were divided into 2 groups: 18 children with the body weight >1500 g and gestation age of > 31 weeks (the 1st group) and 21 children with the body weight < 1500 g and the gestation age of > 30 weeks (the 2nd group). Budesonide was given via a nebulizer 400 μg b.i.d. for 15 days. We assessed FiO 2 in the gas mixture, maximal pressure within mechanical ventilation, the mean pressure in the airways, index of the lung injury, dynamical extension of the chest — lung system. The systemic haemodynamics, carbohydrate metabolism, length of mechanical ventilation and of oxygen therapy, and number of complications were also evaluated. The study demonstrated that inhaled budesonide as a preventive measure against BPD was the most effective in premature newborns with gestation age of < 30 weeks. This drug has not affected the systemic haemodynamics nor carbohydrate metabolism. As a result, number of pulmonary complications and time of treatment in the ICU were reduced.