RT Journal Article
SR Electronic
T1 Dexamethasone treatment during ventilator dependency: possible life threatening gastrointestinal complications.
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 10
OP 11
DO 10.1136/adc.67.1_Spec_No.10
VO 67
IS 1 Spec No
A1 E A O'Neil
A1 W J Chwals
A1 M D O'Shea
A1 C S Turner
YR 1992
UL http://adc.bmj.com/content/67/1_Spec_No/10.abstract
AB Corticosteroids in high doses have been used effectively to decrease the duration of ventilator dependency in very low birthweight infants at risk for chronic lung disease. Randomised prospective studies have shown benefit, with only minimal complications being reported. However, review of our experience over 2.5 years with high dose steroids in 80 premature neonates yielded three major complications: one case each of perforated duodenal ulcer, perforated gastric ulcer, and upper gastrointestinal haemorrhage. Two of the three patients died. Thus the use of steroids in neonates may not be without risk, and significant complications can occur. When high dose corticosteroids are to be used in very low birthweight neonates, H2 receptor antagonist treatment and gastric pH monitoring are recommended. The physician must remain alert to the possibilities of upper gastrointestinal bleeding and ulcer perforation in these patients.