Efficacy of Late Postnatal Dexamethasone on Weaning from Invasive Mechanical Ventilation in Extreme Premature Infants

Objective: To evaluate the short-term respiratory effects of PND in a cohort of ventilator-dependent premature infants.

Study Design: Clinical data from 106 infants 23-28 weeks gestation who received PND for weaning from MV during 2011-2017 were evaluated. PND was started at a dose of 0.1 mg/kg/d tapered over 5-7 d. Treatment success was defined as extubated and free from MV on d14 after start of treatment.

Result: Treatment was successful in 83 (78%) infants. Demographics and age of treatment did not differ between groups. In the failure group, a higher proportion were on HFOV and FiO ≥ 0.50 before treatment, compared to the successful group.

Conclusion: In most infants, PND resulted in successful weaning from MV. Reduced need for oxygen in infants not extubated may be beneficial, but it is unknown if this offsets the risks. The long-term effects PND in ventilator dependent infants need to be evaluated.