Retrospective comparison of the effectiveness of low dose and medium dose dexamethasone treatments in premature babies with a high risk of developing bronchopulmonary dysplasia

Purpose: In order to prevent the development of bronchopulmonary dysplasia (BPD) in preterm babies at risk for the development of BPD, dexamethasone treatment protocols containing different doses have been applied from past to present. This study aimed to compare the effectiveness and side effects of low-dose (cumulative 1 mg/kg) and medium-dose (cumulative 2 mg/kg) dexamethasone treatments used to prevent the development of BPD. Materials and Methods: This study; It was carried out between 01.01.2007 and 30.12.2022 in Karadeniz Technical University Faculty of Medicine Neonatal Intensive Care Unit (NICU) on 89 premature babies who were treated with dexamethasone to prevent the development of BPD and whose file data could be accessed from patients who met the inclusion criteria. The cases were divided into 2 groups and examined retrospectively. There were 30 cases treated with 1 mg/kg cumulative dexamethasone in the Low dose group and 59 cases treated with 2 mg/kg cumulative dexamethasone in the Medium dose group. Results: The demographic characteristics of the cases in both groups were similar. A significant decrease was detected in the mechanical ventilation (MV) parameters applied to the cases in both groups during dexamethasone treatment. (p<0.05). There were no statistically significant differences between the groups in terms of data such as extubation rates during dexamethasone treatment, development of BPD at 36 weeks, development of severe BPD, death or development of BPD at 36 weeks, death or development of severe BPD at 36 weeks, receiving oxygen support at home after discharge, and frequency of second-cycle dexamethasone treatment. (p>0.05). Additionally, there was no statistically significant difference between the groups in terms of MV support, oxygen support and hospital stay (p>0.05). The incidence of hyperglycemia and hypertension during treatment in the low-dose treatment group was statistically significantly lower than in the medium-dose treatment group (p<0.05). There was no statistically significant difference between the groups in terms of other side effects or complications (p>0.05). There was no significant difference between the groups in terms of changes in growth parameters during the treatment process and from the end of treatment to discharge (p>0.05). Conclusion: The positive effects of low-dose and medium-dose dexamethasone treatments in preventing the development of BPD are similar, but the incidence of negative side effects such as hyperglycemia and hypertension was found to be less in the low-dose group. Based on the literature data and the data obtained from this study, it was concluded that it is more appropriate to use low-dose treatment regimens such as cumulative 1 mg/kg instead of medium and high dose dexamethasone treatments. Key words: Bronchopulmonary dysplasia, Low dose dexamethasone treatment, Medium dose dexamethasone treatment.