Intra-tracheal surfactant & budesonide found to be Effective
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A Study was conducted to compare the efficacy of intra-tracheal (IT) surfactant/budesonide (SB) with that of surfactant alone (S) in reducing the rate of bronchopulmonary dysplasia (BPD) at 36 weeks post-menstrual age (PMA), in which extremely preterm very low birth weight (VLBW) infants with severe respiratory distress syndrome (RDS) were included.

A retrospective chart review of two cohorts of extremely preterm VLBW neonates (less than 28+0gestation weeks, birth weight [BW] less than 1500 g) born in two consequent epochs were compared. The SB group received surfactant (200mg/kg 1st dose) and budesonide (0.25 mg/kg), while the S group received surfactant alone.

Results:
--Among 68 neonates with RDS Grades III–IV, FiO2 more than 0.3 within 12 h of life, 18 were included in each group after matching for perinatal, clinical, and laboratory characteristics.

--IT SB did not affect the rate of BPD, death, BPD, or death at 36 weeks PMA.

--Hypotension requiring inotropic support within the first 5 days was lower in those receiving the combined treatment.

--The SB group had fewer admissions to pediatric ward due to respiratory causes up to 12 months of corrected age.

In conclusion, the preliminary findings of this retrospective analysis indicate that intratracheal surfactant/budesonide (SB) for serious respiratory distress syndrome had no effect on the occurrence of BPD, death, or BPD or death at 36 weeks PMA in extremely preterm VLBW infants compared to surfactant alone. In this population, the combined therapy was found to be safe.

Source: https://onlinelibrary.wiley.com/doi/10.1002/ppul.25415?af=R
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