Dirk Bassler.


Van den Anker, M.D., Ph.D., Christoph Meisner, Ph.D., Corinna Engel, Ph.D., Matthias Schwab, M.D., Henry L. Halliday, M.D., and Christian F. Poets, M.D. For the NEUROSIS Trial Group: Early Inhaled Budesonide for preventing Bronchopulmonary Dysplasia About one half of preterm infants have bronchopulmonary dysplasia,1,2 which is a major reason behind early death.1,3 Infants with bronchopulmonary dysplasia who survive have improved dangers of neurodevelopmental respiratory and impairment4 problems later on in life.5,6 Bronchopulmonary dysplasia results from ongoing lung injury and simultaneous repair7,8; swelling linked to chorioamnionitis, postnatal infections, or iatrogenic causes contributes to lung fibrosis and arrested lung advancement.7,9 Systemic glucocorticoids have already been shown to decrease the incidence of bronchopulmonary dysplasia, but they may cause short-term and long-term adverse effects, including intestinal perforation and cerebral palsy.10 A plausible alternative to systemic administration of glucocorticoids is delivery of glucocorticoids simply by inhalation.11 Unfortunately, most trials where this method has been used have already been small or did not initiate administration of glucocorticoids promptly after birth,12 which might be important because the pulmonary inflammatory response in preterm infants in whom bronchopulmonary dysplasia develops starts very early in lifestyle and could even appear prenatally.13-15 We therefore conducted a multinational, randomized trial to test the hypothesis that in preterm infants born before 28 weeks of gestation, inhaled budesonide administered within a day after birth would reduce the incidence of bronchopulmonary dysplasia and death at 36 weeks of postmenstrual age.16 Strategies Study Patients Infants with a gestational age group of 23 weeks 0 days to 27 weeks 6 days and a chronologic age group of 12 hours or less who required any type of positive-pressure support were eligible.

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