Efectos adversos a corto plazo de dexametasona posnatal con dosis bajas para fines de extubación

Introduction

The use of post-natal steroids in the treatment of ventilation-dependent patients is controversial. Dexamethasone has been shown to be an aid in extubation, but its short and long-term adverse effects such as hyperglycaemia, hypertension, gastrointestinal bleeding, and perforation are also well-known.

Objectives

To describe the short-term treatment with dexamethasone scheme at low doses.

Material and methods

A retrospective descriptive study was conducted on patients admitted to neonatal intensive care unit during the period January 2005 to December 2010, and who were maintained with endotracheal intubation for more than 10 days and administered postnatal steroids for extubation. The scheme used was: Newborn infants weighing ≤ 1,500 g, a dose of 0.15 mg/kg/day, and ≥ 1,501 g weight, a dose 0.25 mg/kg/day, reduced by 50% every third day to complete 9 to 12 days of late extubation. An analysis was made of the short-term adverse effects.

Results

A total of 46 patients received post-natal steroids for late extubation. The patient characteristics were as follows: gestational age of between 25 and 39 weeks, and weight 560-3140 g. The mean age when starting on steroids was 34 days. Successful extubation was achieved within 7 days of receiving the post-natal steroid. Only one adverse effect of short-term hyperglycaemia was found in 13.9% of patients. There were no other adverse effects, such as hypertension, gastrointestinal bleeding, or perforation.

Conclusions

In the use of post-natal steroids with low doses to help in extubation, hyperglycaemia was found as a side effect in the short term management with low doses.