Let's Talk about Dex: When do the Benefits of Dexamethasone for Prevention of Bronchopulmonary Dysplasia Outweigh the Risks?
Let's Talk about Dex: When do the Benefits of Dexamethasone for Prevention of Bronchopulmonary Dysplasia Outweigh the Risks?
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DOI：
10.5005/jp-journals-11002-0009
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发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Jordan, Brian K
中科院分区：
文献类型：
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作者：
Nguyen, Thuy;Jordan, Brian K
支气管肺发育不良（BPD）是极早产儿最常见的并发症，并导致儿童和成人呼吸道疾病发病率增加。已证明在早产期间全身给予地塞米松可降低该人群中BPD的发生率。然而，早期的证据表明它可能会对神经发育产生不利影响，这使得人们对它的使用热情有所减弱。最近的研究表明，治疗的时机、剂量和持续时间可能对地塞米松给药的安全性和有效性产生显著影响，如果适当靶向使用，副作用和危害可能会最小化。关注自2010年代美国儿科学会（AAP）关于地塞米松的声明以来发表的研究，本综述旨在检查最近临床试验的证据，以介绍关于全身性地塞米松给药以预防极早产儿BPD的当前知识状态，以及剂量，持续时间和时机如何影响其在该弱势人群中的安全性和有效性。
Bronchopulmonary dysplasia (BPD) is the most common complication of extreme prematurity and carries increased respiratory morbidity into childhood and adulthood. Systemic administration of dexamethasone during the preterm period has been shown to decrease the incidence of BPD in this population. However, enthusiasm about its use has been tempered by early evidence that suggested potential adverse neurodevelopmental outcomes. More recent studies suggest that the timing, dosing, and duration of therapy may have a significant impact on the safety and efficacy of dexamethasone administration and that side effects and harms may be minimized if its use is appropriately targeted. Focusing on studies published since the 2010s American Academy of Pediatrics (AAP) statement on dexamethasone, this review seeks to examine the evidence from recent clinical trials to present the current state of knowledge regarding the systemic dexamethasone administration to prevent BPD in extremely premature infants and how dose, duration, and timing might impact its safety and efficacy in this vulnerable population.