Ömer ERDEVE, Gözde KANMAZ, Banu MUTLU, Uğur DİLMEN, Gonca SANDAL, Zeynep ERASLAN, Şerife Suna OĞUZ

Postnatal oral hydrocortisone in treatment of bronchopulmonary dysplasia: an observational study

Giriş:Çalışmamızın amacı, bronkopulmoner displazi tedavisi için hidrokortizonun düşük dozda bile etkili ve güvenli bir alternatif tedavi olduğunu belirlemektir.Materyal ve Metod: Bu prospektif pilot çalışma Dr. Zekai Tahir Burak Kadın Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesindeki üçüncü düzey yenidoğan yoğun bakım ünitesinde yapıldı. Yaklaşık olarak üç hafta ve üstünde ventilatör bağımlılığı olan (kurtarma tedavisi olarak tanımlandı) veya postkonsepsiyonel 36. haftada herhangi bir infeksiyon kanıtı olmadan oksijen bağımlılığı devam eden (bronkopulmoner displazi tedavisi olarak tanımlandı) preterm bebekler (< 32 gebelik haftası veya < 1500 g doğum ağırlığı) çalışmaya alındı. Hidrokortizon, ilk hafta başlama dozu 1 mg/kg günde iki kez oral olarak, daha sonra klinik yanıta göre %10-20 azaltılarak uygulandı.Bulgular: Toplam 90 infant çalışmaya alındı. Hidrokortizon tedavisinden sonra sadece üç hasta solunumsal destek alıyordu. İlacın güvenilirliği değerlendirildiğinde 8 (%8.8) infantta hidrokortizon tedavisinin erken komplikasyonu gözlendi.Sonuç: Çalışmamız, bildiğimiz kadarıyla literatürde bronkopulmoner displazi tedavisinde hidrokortizon dozu ve başlama zamanı açısından ilk çalışmadır.

Bronkopulmoner displazi tedavisinde postnatal oral hidrokortizon tedavisi: Gözlemsel bir çalışma

Introduction: The aim of our study was to determine whether hydrocortisone even at low dose could be an effective and safe alternative treatment for bronchopulmonary dysplasia.Materials and Methods: This prospective pilot study was conducted in a tertiary referral neonatal intensive care unit placed in Ankara Zekai Tahir Burak Maternity Teaching Hospital. Preterm babies (< 32 week gestational age or < 1500 g birth weight) who were ventilator dependent approximately at or beyond three weeks of age (defined as rescue treatment) or were oxygen dependent on postmenstrual 36th week without evidence of any infection (defined as bronchopulmonary dysplasia treatment) were enrolled in the study. Hydrocortisone was used orally in an initial dose of 1 mg/kg twice a daily for a week and then the dose was tapered by 10-20% every other day regarding to clinical response.Results: A total of 90 infants were enrolled in this study. After hydrocortisone treatment only 3 (3.4%) patients were still on respiratory support. When safety of the drug was evaluated 8 (8.8%) infants had early complications of hydrocortisone treatment.Conclusion: To the best of our knowledge this study is the first trial in the literature along with the hydrocortisone dose and the initiation time in treatment of bronchopulmonary displasia.

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