Prevention of Chronic Lung Disease (CLD) in premature infants with RDS

Exogenous surfactant therapies significantly reduce mortality of the infants. However, the incidence of CLD is not clearly decreased by exogenous surfactant therapies, particulary in very low birth weight infants. The judicious use of diuretics and bronchodilators and the proper use of mechanical ventilation appeared to be beneficial in improving lung function and in decreasing oxygen requirement and barotrauma. However, these effects are often transient and appear to have no long term effect on CLD morbidity. Superoxide Dismutase and vitamin A may reduce CLD, but more studies are needed to confirm this conclusion. Dexamethasone given at two weeks or older does not affect CLD morbidity. The early use of Dexamethasone may decrease lung injuries and improve CLD morbidity. However, in order to avoid immediate side effects and possible long term adverse effect, a modified therapeutic regimen is needed.