March 2016. Volume 12. Number 1

Bronchopulmonary dysplasia and early inhaled budesonide: persist in doing the same or surrender to the evidence?

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

Bassler D, Plavka R, Shinwell ES, Hallman M, Jarreau PH, Carnielli V, Van den Anker JN, Meisner C, Engel C, Schwab M, Halliday HL, Poets CF; NEUROSIS Trial Group. Early Inhaled Budesonide for the Prevention of Bronchopulmonary Dysplasia.N Engl J Med. 2015;373:1497-506.

Reviewers: Rivas Fernández MÁ1, González de Dios J2.
1Hospital General de Cataluña. Sant Cugat del Vallés. Barcelona. España.
2Departamento de Pediatría. Hospital General Universitario de Alicante. España.
Correspondence: Mª Ángeles Rivas Fernández. Email: mayrivas5@gmail.com
Reception date: 09/02/2016
Acceptance date: 16/02/2016
Publication date: 24/02/2016

Abstract

Authors’ conclusions: among extremely preterm infants, the incidence of bronchopulmonary dysplasia was lower among those who received early inhaled budesonide than among those who received placebo, but the advantage may have been gained at the expense of increased mortality.

Reviewers’ commentary: inhaled budesonide, as a prevention measure of bronchopulmonary dysplasia, show inconsistency in the balance between safety and efficacy. Although it seems that might be effective, it is also associated with a trend to increased mortality, not being known if this occurred by chance or due to some undesirable effects. Therefore, pending further studies, it would seem reasonable not to start prophylactic use systematically, and to restrict it only to the cases of bronchopulmonary dysplasia already established and severe.

How to cite this article

Rivas Fernández MA, González de Dios J. Displasia broncopulmonar y budesonida inhalada precoz: ¿persistir o rendirse ante la evidencia? Evid Pediatr. 2016;12:11.

AVC | Critically appraised articles

Bassler D, Plavka R, Shinwell ES, Hallman M, Jarreau PH, Carnielli V, Van den Anker JN, Meisner C, Engel C, Schwab M, Halliday HL, Poets CF; NEUROSIS Trial Group. Early Inhaled Budesonide for the Prevention of Bronchopulmonary Dysplasia.N Engl J Med. 2015;373:1497-506.

Reviewers: Rivas Fernández MÁ1, González de Dios J2.
1Hospital General de Cataluña. Sant Cugat del Vallés. Barcelona. España.
2Departamento de Pediatría. Hospital General Universitario de Alicante. España.
Correspondence: Mª Ángeles Rivas Fernández. Email: mayrivas5@gmail.com
Reception date: 09/02/2016
Acceptance date: 16/02/2016
Publication date: 24/02/2016

How to cite this article

Rivas Fernández MA, González de Dios J. Displasia broncopulmonar y budesonida inhalada precoz: ¿persistir o rendirse ante la evidencia? Evid Pediatr. 2016;12:11.

References

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  2. Doyle LW, Ehrenkranz RA, Halliday HL. Early (< 8 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants. Cochrane Database Syst Rev. 2014;5:CD001969.
  3. Shah V, Ohlsson A, Halliday HL, Dunn MS. Early administration of inhaled corticosteroids for preventing chronic lung disease in ventilated very low birth weight preterm neonates. Cohrane Database Syst Rev. 2012;5:CD001969.
  4. Onland W, Offringa M, van Kaam A. Late (≥ 7 days) inhalation corticosteroids to reduce bronchopulmonary dysplasia in preterm infants. Cochrane Database Syst Rev. 2012;4:CD002311.
  5. Pérez Tarazona S, Rueda Esteban S, Alfonso Diego J, Barrio Gómez de Agüero MI, Callejón Callejón A, Cortell Aznar I, et al. Protocolo de seguimiento de los pacientes con displasia broncopulmonar. An Pediatr (Barc). 2016;61.e1-9.
24/02/2016

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