Efficacy and tolerance of intravenous methylprednisolone pulses in children with severe bronchopulmonary dysplasia requiring respiratory support.

IF 2.7 3区医学 Q1 PEDIATRICS Pediatric Pulmonology Pub Date : 2024-10-22 DOI:10.1002/ppul.27344

Josseline Reynaud, Lélia Dreyfus, Laurianne Coutier, Marine Butin, Isabelle Godbert, Florent Baudin, Côme Horvat, Philippe Reix

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Abstract

Objectives: Bronchopulmonary dysplasia (BPD) is a chronic lung disease that affects premature babies and contributes to their morbidity. French BPD guidelines suggest the use of intravenous methylprednisolone pulses (IVMP) for those who require respiratory support (RS) following 36 weeks postmenstrual age (PMA). However, there is scant data on the efficacy and tolerance for this indication. Our objectives were to assess the efficacy and tolerance of IVMP in patients with severe BPD requiring RS.

Study and design: This retrospective observational study included preterm infants (<32 weeks gestational age) treated by IVMP between January 2016 and March 2021, in a single tertiary care hospital. The primary endpoint was signified by changes in the Pulmonary Severity Score (PSS). Our secondary endpoints were changes in RS and the tolerance of IVMP.

Results: Data of 14 children with BPD under RS were reviewed. Their median [IQR] gestational age at birth was (26[26-29.5] weeks). After IVMP administration, the PSS did not improve significantly from baseline day 0 (D0) (0.85[0.55-1.15]) to D7 (0.74 [0.48-1.00]) or Month 1 (1.02 [0.57-1.48]). Three children (21%) experienced a decrease in RS in the following month of IVMP. There was no negative short-term impact on growth. Five infants presented infectious complications. The development quotient was measured in 5 children at 2 years of age.

Conclusion: In our study, IVMP did not improve PSS and it was associated with a high number of infections. Other studies are needed to better define the place of IVMP in these infants.

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目的：支气管肺发育不良（BPD）是一种影响早产儿的慢性肺部疾病，也是早产儿发病率较高的原因之一。法国的 BPD 指南建议对月龄后 36 周后需要呼吸支持（RS）的婴儿使用静脉甲基强的松龙脉冲（IVMP）。然而，有关这一适应症的疗效和耐受性的数据却很少。我们的目标是评估 IVMP 在需要 RS 的严重 BPD 患者中的疗效和耐受性：研究与设计：这项回顾性观察研究包括早产儿（结果：14 名需要使用 RS 的严重 BPD 患儿的数据）：研究回顾了 14 名需要使用 RS 的 BPD 患儿的数据。他们出生时的胎龄中位数[IQR]为（26[26-29.5]周）。给予 IVMP 后，PSS 从基线第 0 天（D0）（0.85[0.55-1.15]）到第 7 天（0.74 [0.48-1.00]）或第 1 个月（1.02 [0.57-1.48]）均无明显改善。有 3 名儿童（21%）在接受 IVMP 治疗的下一个月出现 RS 下降。短期内对生长没有负面影响。5 名婴儿出现了感染并发症。5 名婴儿在 2 岁时进行了发育商数测量：在我们的研究中，IVMP 没有改善 PSS，而且与大量感染有关。需要进行其他研究，以更好地确定 IVMP 在这些婴儿中的地位。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.