Effects of Dexamethasone Treatment on Blood Pressure in Preterm Infants with Chronic Lung Disease (CLD)

ABSTRACT

PURPOSE: This study was designed to see the BP changes according to the time course and the duration of dexamethasone (DXM) therapy in premature infants with chronic lung disease (CLD). METHODS: We studied 27 chronic lung disease patients treated with DXM in NICU, Chonnam University Hospital from January 1994 to May 1998. Systolic, diastolic, and mean arterial pressure were recorded at three times (8 AM, 4 PM, midnight) daily. Data were analyzed by time peroid Pre DXM means 14 days before DXM therapy, DXM during the therapy and Post DXM 14 days after the completion of therapy. Of 27 patients, 16 received short-course (7 days), and 11 long-course therapy (42 days). RESULTS: Mean gestational age of the patients was 29.3 (+/-1.5) weeks and the mean birth weight was 1,169 (+/-262) gm. Systolic, diastolic and mean BP were significantly increased during the DXM therapy compared to pre DXM (76+/-7 mmHg vs 67+/-9 mmHg, P<0.001, 44+/-6 mmHg vs 38+/-6 mmHg, P<0.001, 55+/-6 mmHg vs 49+/-7 mmHg, P<0.001, respectively). Even 14 days after the completion of therapy, systolic, diastolic and mean BP were not decreased to the level of pre DXM therapy. The maximal increase of BP was noted on the second day of treatment. When the BP changes were compared according to the duration of therapy, post DXM BP was decreased to the level of pre DXM in short course, but not in long course group with the higher post DXM systolic BP than that of short course group (78+/-11 mmHg vs 69+/-7 mmHg, P<0.05). CONCLUSION: BP significantly increased during DXM therapy, particularily on the second day of treatment. Also our result suggests that we have to watch the BP carefully more than two weeks after the completion of therapy.