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Use of inhaled steroids to prevent bronchopulmonary dysplasia: a matter of great debate
  1. Samira Samiee-Zafarghandy1,
  2. John N van den Anker2,3
  1. 1 Division of Neonatology, Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada
  2. 2 Division of Paediatric Pharmacology and Pharmacometrics, University of Basel Children’s Hospital, Basel, Switzerland
  3. 3 Division of Clinical Pharmacology, Children’s National Health System, Washington, District of Columbia, USA
  1. Correspondence to Dr Samira Samiee-Zafarghandy, Division of Neonatology, Department of Paediatrics, McMaster University, Hamilton ON L8S 4L8, Canada; samiees{at}

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In recent years, there has been a significant increase in the use of inhaled corticosteroids for the prevention of bronchopulmonary dysplasia (BPD) in premature infants.1 Studies have shown a decrease in the rate of BPD and need for prolonged mechanical ventilation. The largest study, to date, investigated the early use of inhaled budesonide in preterm infants and showed a significant decrease in the rate of BPD but a higher mortality rate in the exposure group.2 In this study, the causes of mortality did not differ between inhaled budesonide and placebo group, and the difference in the rate of death appeared to originate from a single centre. This increased mortality had also not been shown in any of previous trials. Nevertheless, this result warrants caution for routine early use of inhaled steroids …

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  • Contributors SS-Z made substantial contribution to the concept of the letter, review of the literature, and drafting the work and its critical revision. JNvdA made substantial contribution to the concept of the letter and its critical revision for intellectual content. Both authors approved the final version of the manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Author note The authors attest that the manuscript is being submitted only to the Archives of Disease in Childhood, that it will not be submitted elsewhere while under consideration and that it has not been published elsewhere.