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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}mcmaster.ca

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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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