FETAL AND NEONATAL MEDICINE
Effectiveness of dexamethasone in preventing extubation failure in preterm infants at increased risk for airway edema Robert J. Couser, MD, T. Bruce Ferrara, MD, Brenda Falde, CRTT, RPFT, Katie Johnson, RRT,RPFT,Craig G. Schilling, PharmD, a n d Ronald E. Hoekstra, MD From the Division of Neonatology, Minneapolis Children's Medical Center, Minneapolis, Minnesota We studied 50 preterm infants who had multiple or traumatic e n d o t r a c h e a l intubations, or whose duration of e n d o t r a c h e a l intubation was >__14days, and who were considered at high risk for airway e d e m a . These infants were enrolled in a prospective, randomized, controlled clinical trial to assess whether prophylactic d e x a m e t h a s o n e therapy would be effective in the prevention of postextubation stridor and respiratory distress. At study entry, both groups had similar weights, postnatal ages, methylxanthine use, ventilator settings, b l o o d gas values, and pulmonary function test results (dynamic c o m p l i a n c e , total respiratory resistance, tidal volume, p e a k - t o - p e a k transpulmonary pressure, minute ventilation, and p e a k inspiratory and expiratory flow rates). Patients underwent b l o o d gas studies, physical examinations, and pulmonary function testing at baseline (4 hours before extubation) and again 2 to 4 hours and 18 to 24 hours after extubation. Twenty-seven infants received d e x a m e t h a s o n e , 0.25 m g / k g per dose, at baseline, and then every 8 hours for a total of three doses; 23 infants received saline solution at corresponding times. Eighteen to twenty-four hours after extubation, total pulmonary resistance increased by 225% from baseline in the control group c o m p a r e d with 33% in the d e x a m e t h a s o n e group (p
Effectiveness of dexamethasone in preventing extubation failure in preterm infants at increased risk for airway edema Robert J. Couser, MD, T. Bruce Ferrara, MD, Brenda Falde, CRTT, RPFT, Katie Johnson, RRT,RPFT,Craig G. Schilling, PharmD, a n d Ronald E. Hoekstra, MD From the Division of Neonatology, Minneapolis Children's Medical Center, Minneapolis, Minnesota We studied 50 preterm infants who had multiple or traumatic e n d o t r a c h e a l intubations, or whose duration of e n d o t r a c h e a l intubation was >__14days, and who were considered at high risk for airway e d e m a . These infants were enrolled in a prospective, randomized, controlled clinical trial to assess whether prophylactic d e x a m e t h a s o n e therapy would be effective in the prevention of postextubation stridor and respiratory distress. At study entry, both groups had similar weights, postnatal ages, methylxanthine use, ventilator settings, b l o o d gas values, and pulmonary function test results (dynamic c o m p l i a n c e , total respiratory resistance, tidal volume, p e a k - t o - p e a k transpulmonary pressure, minute ventilation, and p e a k inspiratory and expiratory flow rates). Patients underwent b l o o d gas studies, physical examinations, and pulmonary function testing at baseline (4 hours before extubation) and again 2 to 4 hours and 18 to 24 hours after extubation. Twenty-seven infants received d e x a m e t h a s o n e , 0.25 m g / k g per dose, at baseline, and then every 8 hours for a total of three doses; 23 infants received saline solution at corresponding times. Eighteen to twenty-four hours after extubation, total pulmonary resistance increased by 225% from baseline in the control group c o m p a r e d with 33% in the d e x a m e t h a s o n e group (p
