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PO-0751 Use Of Postnatal Steroids In Ventilator Dependant Preterm Infants
  1. N Merchant1,
  2. A Zovidavi2,
  3. H Cullen1,
  4. A Huertas-Ceballos2,
  5. S Watkin2
  1. 1Centre for the Developing Brain Perinatal Imaging and Health, King’s College London, London, UK
  2. 2Neonatology, University College London Hospital, London, UK

Abstract

Background and aim Bronchopulmonary Dysplasia (BPD), results in prolonged hospitalisation, poor growth and adverseneurodevelopment outcome. Postnatal steroids may decrease prolonged ventilation, one of the risk factors for BPD. However, there are concerns about adverse effects of steroids.

The aim of the study was to assess the safety and efficacy of hydrocortisonein ventilator dependant preterm infants, thus ensuring safe practice and improve the quality of care given.

Methods The study was a retrospective analysis over 17 months (Jan 2012–May 2013) in preterm infants less than 32 weeks gestation. Demographic data along with data on adverse effects related to hydrocortisone was collected.

Results Fifteen percent (42/281) of preterm infants received hydrocortisone starting at dose of 5 mg/kg/d to aid extubation. The mean gestation was 25.17 weeks with a mean birth weight of 696 g. Forty-six percent had more than one failed extubation, 54% required >90% oxygen pre-treatment and 70% had either medical or surgical intervention for PDA. Only 24% had a documented discussion with parents regarding steroid treatment. The dose was reduced by 0.5–1 mg/kg, the time frequency of reduction varied between 1–7 days.

Adverse events related to hydrocortisone treatment included hypertension, oesophageal perforation, hyponatremic, hyperglycaemic requiring insulin, left ventricular hypertrophy, fractures and poor weight gain.

Conclusions The incidence of steroid use reflected that of other centres. Awareness of adverse events related to use of steroids along with improved parental communication is required.

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