Efficacy of different preparations of budesonide combined with pulmonary surfactant in the treatment of neonatal respiratory distress syndrome: a comparative analysis
KE Hua, LI Zhan-Kui, YU Xi-Ping, GUO Jin-Zhen
Department of Neonatology, Northwest Women and Children's Hospital, Xi'an 710061, China
Abstract Objective To study the efficacy of different preparations of budesonide combined with pulmonary surfactant (PS) in improving blood gas levels and preventing bronchopulmonary dysplasia (BPD) in preterm infants with neonatal respiratory distress syndrome (NRDS). Methods A total of 184 preterm infants who developed NRDS within 4 hours after birth were randomly administered with PS + continuous inhalation of budesonide aerosol (continuous aerosol group), PS+budesonide solution (solution group), PS + single inhalation of budesonide aerosol (single aerosol group), and PS alone, with 46 neonates in each group. The changes in arterial blood gas levels, rate of invasive mechanical ventilation after treatment, time of assisted ventilation, rate of repeated use of PS, and the incidence of BPD were compared between the four groups. Results On the 2nd to 4th day after treatment, pH, PCO2, and oxygenation index (FiO2/PaO2) showed significant differences among the four groups, and the continuous aerosol group showed the most improvements of all indicators, followed by the solution group, single aerosol group, and PS alone group. The continuous aerosol group had a significantly shorter time of assisted ventilation than the other three groups (PPPConclusions A combination of PS and continuous inhalation of budesonide aerosol has a better efficacy in the treatment of NRDS than a combination of PS and budesonide solution. The difference in reducing the incidence of BDP between the two administration methods awaits further investigation with a larger sample size.
KE Hua,LI Zhan-Kui,YU Xi-Ping et al. Efficacy of different preparations of budesonide combined with pulmonary surfactant in the treatment of neonatal respiratory distress syndrome: a comparative analysis[J]. CJCP, 2016, 18(5): 400-404.
KE Hua,LI Zhan-Kui,YU Xi-Ping et al. Efficacy of different preparations of budesonide combined with pulmonary surfactant in the treatment of neonatal respiratory distress syndrome: a comparative analysis[J]. CJCP, 2016, 18(5): 400-404.
Kasat K, Patel H, Predtechenska O, et al. Anti-inflammatory actions of endogenous and exogenous interleukin-10 versus glucocorticoids on macrophage functions of the newly born [J]. J Perinatol, 2014, 34(5): 380-385.
[2]
Tanney K, Davis J, Halliday HL, et al. Extremely low-dose dexamethasone to facilitate extubation in mechanically ventilated preterm babies [J]. Neonatology, 2011, 100(3): 285-289.
Slaughter JL, Stenger MR, Reagan PB, et al. Utilization of inhaled corticosteroids for infants with bronchopulmonary dysplasia[J]. PLoS One, 2014, 9(9): e106838.
[7]
Carvalho CG, Silveira RC, Procianoy RS. Ventilator-induced lung injury in preterm infants[J]. Rev Bras Ter Intensiva, 2013, 25(4): 319-326.
[8]
Kuo HT, Lin HC, Tsai CH, et al. A follow-up study of preterm infants given budesonide using surfactant as a vehicle to prevent chronic lung disease in preterm infants[J]. J Pediatr, 2010, 156(4): 537-541.
[9]
Yang CF, Lin CH, Chiou SY, et al. Intratracheal budesonide supplementation in addition to surfactant improves pulmonary outcome in surfactant-depleted newborn piglets[J]. Pediatr Pulmonol, 2013, 48(2): 151-159.
[10]
Meltzer EO, Pearlman DS, Eckerwall G, et al. Efficacy and safety of budesonide administered by pressurized metereddose inhaler in children with asthma[J]. Ann Allerqy Asthma Immunol, 2015, 115(6): 516-522.
