Effect Of Different Inhaled Budesonide Strategies On Clinical Outcomes In Preterm Infants With Bronchopulmonary Dysplasia

Objective:To investigate the effect of inhaled budesonide at different time on clinical outcomes in preterm infants with bronchopulmonary dysplasia.Methods:This retrospective study was enrolled 78 preterm infants with bronchopulmonary dysplasia admitted to the neonatal department of Children’s Hospital of Chongqing Medical University from January 2012 to December 2015. According to the postnatal age of budesonide inhalation, they were divided into the early inhalation group(<28 day) and the late inhalation group(≥28 day). Collecting clinical data of the two groups to analyze their basic information, perinatal situation, the complication during hospitalization, respiratory support conditions and other interventions and to compare the total duration of oxygen supplement during hospitalization, severity of BPD, the length of hospitalization and short-time adverse effects including hypertension, hyperglycemia, NEC,etc. T-test or rank sum test was chosen for continuous variables, Chi-square test or Fisher’s exact test for categorical variables. P values of less than 0.05 were considered to indicate statistical significance.Results:The basic information, perinatal situation, the complication, respiratory support conditions and other interventions were not statistical difference between two groups. Compared with the late inhalation group, the total duration of oxygen supplement during hospitalization(42.8±11.6d vs 50.6±13.9d,P<0.05) and the length of hospital stay were shorter in early inhalation group[43(35~56)d vs 57(44~63.5)d, P<0.05]. There was significant in the severity of BPD between groups. The incidence of mild BPD is higher,and moderate or severe BPD is lower in early inhalation group(72.7% vs 44.4%, 21.2% vs 40%, 6.4% vs 15.6%, respectively).No hypertension and NEC occurred in the two groups. Compared with the late inhalation group, the incidence of hyperglycemia and gastrointestinal heamorrhage was lower in the early inhalation group, but they were both no significant difference.Conclusion:In this study, early inhaled budesonide to treat preterm infants with bronchopulmonary dysplasia may be able to shorten the duration of oxygen supplement and the length of hospitalization and alleviate the severity of BPD without increasing the incidence of short-term adverse effects. Early inhaled budesonide can significantly improve the short-term outcomes of infants with BPD, safely and effectively. Further multicenter large-scale randomized studies on the efficacy, safety and the optimal timing of inhaled budesonide preventing or treating preterm infants with BPD is needed.