Postnatal corticosteroids to prevent or treat bronchopulmonary dysplasia - Who might benefit?
Postnatal corticosteroids to prevent or treat bronchopulmonary dysplasia - Who might benefit?
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DOI：
10.1016/j.siny.2017.07.003
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发表时间：
2017-10-01
影响因子：
3
通讯作者：
Cheong, Jeanie L. Y.
中科院分区：
文献类型：
--
作者：
Doyle, Lex W.;Cheong, Jeanie L. Y.
非常早产的新生儿发生支气管肺发育不良的风险很高，这不仅与死亡率有关，而且与幸存者的长期不良神经和呼吸结果有关。产后皮质类固醇可降低支气管肺发育不良的风险，或降低其严重程度。然而，重要的是尽量减少暴露于皮质类固醇的潜在有害影响，特别是对发育中的大脑。出生后第一周开始使用全身性皮质类固醇对支气管肺发育不良风险最高的婴儿最有益，而吸入皮质类固醇对已确诊肺部疾病的儿童效果甚微。不建议在出生后第一周全身性使用皮质类固醇，但吸入皮质类固醇，或使用表面活性剂将皮质类固醇注入气管，作为将皮质类固醇分配到肺部的载体，有望预防支气管肺发育不良。(C) 2017 Elsevier Ltd.版权所有。
Newborn infants born very preterm are at high risk of developing bronchopulmonary dysplasia, which is associated with not only mortality but also adverse long-term neurological and respiratory outcomes in survivors. Postnatal corticosteroids might reduce the risk of developing bronchopulmonary dysplasia, or reduce its severity. However, it is important to minimize exposure to the potentially harmful effects of corticosteroids, particularly on the developing brain. Systemic corticosteroids started after the first week of life have shown the most benefit in infants at highest risk of developing bronchopulmonary dysplasia, whereas inhaled corticosteroids have little effect in children with established lung disease. Systemic corticosteroids in the first week of life are not recommended, but inhaled corticosteroids, or corticosteroids instilled into the trachea using surfactant as a vehicle to distribute the corticosteroids through the lungs, offer promise with respect to prevention of bronchopulmonary dysplasia. (C) 2017 Elsevier Ltd. All rights reserved.