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Inhaled postnatal corticosteroids demonstrate low systemic bioavailability and rapid systemic clearance with high pulmonary deposition and were expected to reduce the incidence of BPD with reduced adverse effects, however, increased rate of mortality in the neonatal period and at the 18\u201324 months follow\u2010up was observed. In a milestone study, intratracheal instillation of corticosteroids combined with surfactant decreased the incidence of BPD without increasing the mortality or the long\u2010term neurodevelopmental adverse outcomes. However, subsequent trials using different types of surfactants, different surfactant to budesonide ratio, different time of the drug administration for infants with different severity of respiratory distress syndrome could not reproduce all the beneficial effects. Future perspectives for the identification of premature infants at high risk of BPD and the prevention or treatment of established BPD are discussed.<\/jats:p>","DOI":"10.1002\/ppul.25808","type":"journal-article","created":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T10:38:29Z","timestamp":1640774309000},"page":"787-795","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Corticosteroids in the prevention and treatment of infants with bronchopulmonary dysplasia: Part II. Inhaled corticosteroids alone or in combination with surfactants"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0612-5851","authenticated-orcid":false,"given":"Hajnalka","family":"Szab\u00f3","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine &amp; Albert Szent\u2010Gy\u00f6rgyi Health Center University of Szeged Szeged Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1829-3652","authenticated-orcid":false,"given":"Eugenio","family":"Baraldi","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Department of Woman's and Child's Health Padova University Hospital Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2693-2733","authenticated-orcid":false,"given":"Andrew A.","family":"Colin","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology, Miller School of Medicine University of Miami Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196702162760701"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000497422"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9051539"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25301"},{"key":"e_1_2_9_6_1","article-title":"Corticosteroids in the prevention and treatment of infants with bronchopulmonary dysplasia: Part I. 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