Bronkopulmoner Displazide Önleyici Ve Tedavi Amaçlı İnhale Veya Sistemik Steroid Kullanımı: Güncel Bir Derleme

Abstract

Bronkopulmoner displazi patogenezinde mekanik ventilasyon kaynaklı basınç ve/veya hacim travması, oksijen toksisitesi, enfeksiyon, azalmış surfaktan üretimi ve artmış akciğer kan akımı ile ilişkilendirilen inflamasyon suçlanır. İnflamasyon sürecinin durdurulması amaçlı sistemik ve inhale steroidler kullanılmaktadır. Bu yazıda, bronkopulmoner displazi tedavisinde kullanılan sistemik ve inhale steroidlerin gözden geçirilmesi ve bu konuda varılan görüş birliğinin tartışılması amaçlanmıştır.

Keywords

• Bronkopulmoner displazi, prematürite, steroid, tedavi

INHALED OR SYSTEMIC STEROID USE FOR PREVENTIVE AND MANAGEMENT PURPOSES IN BRONCHOPULMONARY DYSPLASIA: A CURRENT REVIEW

Abstract

Inflammation related to mechanical ventilation induced baro and/or volume trauma, oxygen toxicity, infection, decreased surfactant production and increased pulmonary blood flow is accused for bronchopulmonary dysplasia pathogenesis. Systemic or inhalated steroids are used to stop the inflammatory process. Herein, it is aimed to review the systemic and inhalated steroids used in bronchopulmonary dysplasia and discuss the consensus in this subject

Keywords

• Bronchopulmonary dysplasia, prematurity, steroid, treatment

References

1. Bhandari A, Schramm CM, Kimble C, Pappagallo M, Hussain N. Effect of a short course of prednisolone in infants with oxygen dependent bronchopulmonary dysplasia. Pediatrics 2008;121:344
2. Bancalari E. Changes in the pathogenesis and prevention of chro- nic lung disease of prematurity. Am J Perinatol 2001;18:1–9.
3. Walsh MC, Yao Q, Horbar JD, Carpenter JH, Lee Sk, Ohlsson A. Changes in the use of postnatal steroids for BPD in 3 large neonatal networks. Pediatrics 2006;118:1328-1335.
4. Hallman M, Peltoniemi O, Saarela T. Early neonatal hydrocortiso- ne: study rather than treat. Pediatrics 2006;118:2540-2542.
5. Eichenwald EC, Stark AR. Are postnatal steroids ever justified to treat severe bronchopulmonary dysplasia? Arch Dis Child Fetal Neonatal Ed 2007;92:334-337.
6. Thebaud B, Watterberg K. Postnatal glucocorticoids in very preterm infants: “The good, the bad, and the ugly”? Pediatrics ;107;413-415. Jones BO, Davies MW. Total steroid dose given to ventilated new- born infants with chronic lung disease. J Paediatr Child Health ;43:40-43. Cole CH, Colton T, Shah B, Abbasi S, MacKinnon BL, Demisse S, Frantz ID 3rd. Early inhaled glucocorticoid therapy to prevent bronchopulmonary dysplasia. N Engl J Med 1999;340:1005
7. Zimmerman JJ, Gabbert D, Shivpuri C, Kayata S, Miller J, Ciesi- elski W. Meter-dosed, inhaled beclomethasone initiated at birth to prevent bronchopulmonary dysplasia. Pediatr Crit Care Med ;1:140-145. Cummings JJ, D’Eugionio DB, Gross SJ. A controlled trial of de- xamethasone in preterm infants at high risk of bronchopulmo- nary dysplasia. N Engl J Med 1989;320:1505-1510.
8. American Academy of Pediatrics, Canadian Paediatric Society. Postnatal corticosteroids to treat or prevent chronic lung disease in preterm infants. Pediatrics 2002;109:330-338.

9. Canadian Paediatric Society. Postnatal corticosteroids to treat or prevent chronic lung disease in preterm infants. J Paediatr Child Health 2002;7:20-28.
10. Barrington KJ. The adverse neuro-developmental effects of post- natal steroids in the preterm infant: a systemic review of RCTs. BCM Pediatrics 2001;1:1.
11. Yeh TF, Lin YJ, Lin HC,Huang CC, Hsieh WS, Lin CH, Tsai CH. Outcomes at school age after postnatal dexamethasone therapy for lung disease of prematurity. N Engl J Med 2004;350:1304
12. Parikh NA, Lasky RE, Kennedy KA, Moya FR, Hochhauser L, Romo S, Tyson JE. Postnatal dexamethasone therapy and cerebral tissue volumes in extremely low birth weight infants. Pediatrics ;119:265-272. Halliday HL, Ehrenkranz RA, Doyle LW. Early postnatal (<96 ho- urs) corticosteroids for preventing chronic lung disease in preterm infants. Cochrane Database Syst Rev 2003;1:1146.
13. Halliday HL, Ehrenkranz RA, Doyle LW. Moderately early (7-14 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants. Cochrane Database Syst Rev 2003;1:1144.
14. Halliday HL, Ehrenkranz RA, Doyle LW. Delayed (>3 weeks) postnatal corticosteroids for preventing chronic lung disease in preterm infants. Cochrane Database Syst Rev 2003;1:1145.
15. Doyle LW, Davis PG, Morley CJ, McPhee A, Carlin JB: DART Study Investigators. Low dose dexamethasone facilitates extubati- on among chronically ventilator-dependent infants: A multicenter, international, randomized, controlled trial. Pediatrics 2006;117:75
16. Smolkin T, Steinberg M, Sujov E, Mezer E, Tamir A, Makhoul IR. Late postnatal systemic steroids predispose to retinopathy of prematurity in very-low-birth-weight infants: a comparative study. Acta Paediatrica 2008;97:322-326.
17. Ohlsson A, Calvert SA, Hosking M, Shennan AT. Randomized controlled trial of dexamethasone treatment in very-low-birth- weight infants with ventilator-dependent chronic lung disease. Acta Paediatr 1992;81:751–756.
18. Avery GB, Fletcher AB, Kaplan M, Brudno DS. Controlled trial of dexamethasone in respirator-dependent infants with broncho- pulmonary dysplasia. Pediatrics 1985;75:106–111.
19. Powell K, Kerkering KW, Barker G, Rozycki HJ. Dexamethasone dosing, mechanical ventilation and the risk of cerebral palsy. J Ma- ternal Fetal Neonatal Med 2006;19:43-48.
20. Fok TF, Lam K, Dolovich M, Ng PC, Wong W, Cheung KL, So KW. Randomised controlled study of early use of inhaled corti- costeroid in preterm infants with respiratory distress syndrome. Arch Dis Child Fetal Neonatal Ed 1999;80:203–208.
21. Merz U, Kusenbach G, Hausler M, Peschgens T, Hornchen H. In- haled budesonide in ventilator-dependent preterm infants: a ran- domized, double-blind pilot study. Biol Neonate 1999;75:46–53.
22. Denjean A, Paris-Llado J, Zupan V, Debillon T, Kieffer F, Magny JF, Desfreres L, Llanas B, Guimaraes H, Moriette G, Voyer M, Dehan M, Breart G. Inhaled salbutamol and beclomethasone for preventing broncho-pulmonary dysplasia: a randomised double blind study. Eur J Pediatr 1998;157:926–931.
23. Arnon S, Grigg J, Silverman M. Effectiveness of budesonide aero- sol in ventilator-dependent preterm babies: a preliminary report. Pediatr Pulmonol 1996;21:231–235.
24. Giep T, Raibble P, Zuerlein T, Schwartz ID. Trial of beclomethaso- ne dipropionate by metered-dose inhaler in ventilator-dependent neonates less than 1500 grams. Am J Perinatol 1996;13:5–9.
25. Dugas MA, Nguyen D, Frenette L, Lachance C, St-Onge O, Fou- geres A, Belanger S, Caouette G, Proulx E, Racine MC, Piedboeuf B. Fluticasone inhalation in moderate cases of bronchopulmonary dysplasia. Pediatrics 2005;115:566–572.
26. Pantalitschka T, Poets CF. Inhaled drugs for prevention and treatment of bronchopulmonary dysplasia. Pediatr Pulmonol ;41:703-708.