PGY1 Pharmacy Resident Children's Hospital Colorado Denver, Colorado, United States
Background: Bronchopulmonary dysplasia (BPD) is a common morbidity associated with prematurity. Corticosteroids are often used with the goals of extubating infants from mechanical ventilation, improving pulmonary compliance, weaning respiratory support, and extubating infants sooner to reduce exposure to invasive mechanical ventilation. However, there is wide variation in the steroid type, dose, and duration administered to preterm infants. Determining predictors of postnatal corticosteroid responsiveness to facilitate weaning of respiratory support remains challenging and currently lacks objective guidance. Objective: Among infants who remain intubated and receive their first steroid course for pulmonary indications at >7 days of life, we aim to 1) describe the clinical characteristics and change in Respiratory Severity Score (RSS) at multiple time points during steroid course, and 2) assess association between steroid exposure and successful wean of respiratory support, defined as a decrease in support by one parameter (ex: High Frequency Oscillator Ventilation to Mechanical Ventilation, Mechanical Ventilation to Non-invasive Ventilation, etc.) and/or fraction of inspired oxygen (FiO2) decrease by >0.2, or extubation within 48 hours of course completion. Design/Methods: This retrospective cohort study was approved by the local institutional review board. Preterm infants < 29 weeks gestation admitted to a level IV NICU and intubated at ≥7 days of life between January 1, 2015, and July 31, 2023 with any systemic steroid exposure for respiratory indications were included in the study. Patients who transitioned to another steroid during the initial steroid course or received steroids for non-respiratory indications will be excluded. Descriptive statistics and regression analysis will be performed upon completion of data collection by February 2024.
