A 42 day tapering course of dexamethasone reduced duration of assisted ventilation in very low birthweight infants, but increased risk of cerebral palsy at age 1 year
QUESTION: Among very low birthweight infants, does a 42 day course of dexamethasone reduce duration of assisted ventilation and affect developmental outcome at age 1 year?
Randomised (allocation concealed*), unblinded, placebo controlled trial with follow up at age 1 year.
2 neonatal intensive care units (NICUs) in North Carolina, USA.
118 infants (53% boys, 61% white) who were 15–25 days old and had birth weight <1501 g; <10% decrease in ventilator settings for the previous 24 hours and fraction of inspired oxygen (FIO2) ≥0.3; no clinical signs of sepsis; and no echocardiographic evidence of patent ductus arteriosus. 95 infants (81%) survived to 1 year adjusted age; 93 of these surviving infants completed follow up.
57 infants were allocated to dexamethasone, 0.25 mg/kg twice each day for 3 days, then 0.15 mg/kg twice each day for 3 days, then a 10% reduction in dose every 3 days until a 0.1 mg/kg dose …