Table 3.
Clinical approaches to prevent ROS-induced lung injury and BPD—anti-inflammatory drugs.
| Intervention | Study Design | Study Population | Primary Outcome | Effect on BPD/Lung Injury | Reference |
|---|---|---|---|---|---|
| Postnatal corticosteroids (early, <8 d) (supplementation vs. placebo or control) |
Cochrane Database Syst Rev. included trials (RCTs): 32 |
n = 4445 GA < 37 |
mortality BPD (at 28 days of life, at 36 weeks PMA, and at 36 weeks PMA in survivors) death or BPD (at 28 days of life and at 36 weeks PMA) long-term outcomes |
early corticosteroids reduced the incidence of BPD at 28 days of life (RR 0.87; 95% CI 0.81-0.93) and at 36 weeks PMA (RR 0.79; 95% CI 0.72–0.87) | [82] |
| Postnatal corticosteroids (late, >7 d) (supplementation vs. placebo or control) |
Cochrane Database Syst Rev. included trials (RCTs): 21 |
n = 1424 | chronic lung diesease (mortality and/or BPD at 36 weeks PMA) | reduction of BPD (RR 0.77; 95% CI 0.67–0.88) and combined outcome death or BPD (RR 0.77; 95% CI 0.70–0.86) | [83] |
| early (within 24 h after birth) inhaled budesonide (supplementation vs. placebo) |
RCT | n = 863 GA > 23 < 28 |
death or BPD (confirmed by means of standardized oxygen-saturation monitoring at a 36 weeks PMA) | death or BPD was lower in the budesonide group, but the advantage may have been gained at the expense of increased mortality (RR 0.86; 95% CI 0.75–1.00; p = 0.05; OR 0.71; 95% CI 0.53–0.97) | [85] |
| intratracheal administration of surfactant/budesonide vs. surfactant alone | Clinical trial | n = 265 BW < 1500 g |
death or BPD (supplemental oxygen at 36 weeks PMA) | lower incidence of BPD or death in intervention group (RR 0.58; 95% CI 0.44–0.77; p < 0.01) | [87] |
| Vitamin D (birth levels in BPD infants vs. control) |
Meta-analysis, included trials: 8 | n= 909 | BPD (oxygen dependency at either 28 days of age or 36 weeks PMA) | BPD was associated with vitamin D deficiency at birth (OR 2.405; 95% CI 1.269–4.560; p = 0.007) and low levels at birth (standardized mean difference −1.463; 95% CI −2.900–0.027; p = 0.046) | [88] |
n—number; BW—birth weight; GA—gestational age; BPD—bronchopulmonary dysplasia; RCT—randomized controlled trial; PMA—postmenstrual age; RR—relative risk; CI—confidence interval.