{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T22:02:24Z","timestamp":1765231344182,"version":"3.37.3"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003This study aimed to determine the effect of intratracheal instillation of a budesonide\u2013surfactant combination on the incidence of bronchopulmonary dysplasia (BPD) or death compared with surfactant alone in extremely preterm infants.<\/jats:p><jats:p>\n            Study Design In this retrospective, single-center study, we included extremely preterm infants (&lt;28 weeks' gestation) who received surfactant for respiratory distress in the first 3 days of life. We compared infants who received budesonide\u2013surfactant combination (intervention group: infants born between February 2016 and October 2021) with surfactant alone (control group: infants born from January 2010 through January 2016). The primary outcome was a composite of BPD grade 2 or 3 (as defined by Jensen et al, 2019) or death before 36 weeks' postmenstrual age (PMA).<\/jats:p><jats:p>\n            Results\u2003We included 966 extremely preterm infants (528 in the control group and 438 in the intervention group). While the incidence of death\/BPD grade 2 or 3 at 36 weeks of PMA was not different between the two groups (66% in the intervention group vs. 63% in the control group; adjusted relative risk [aRR], 0.99; 95% confidence interval [CI], 0.90\u20131.07; p-value\u2009=\u20090.69), budesonide was associated with a reduction in the primary outcome only in a subgroup of infants with birth weight \u2265 750 grams (36.8 vs. 43.5%, respectively; aRR 0.75; 95% CI, 0.57\u20130.98). Primary and secondary outcomes did not differ between the two groups within the subgroup of infants weighing &lt;750 grams.<\/jats:p><jats:p>\n            Conclusion\u2003In extremely preterm infants, the budesonide\u2013surfactant combination therapy reduced the rates of BPD or death in infants weighing \u2265750 grams; however, this beneficial effect was not seen in infants weighing &lt;750 grams. Further investigation of this treatment may be indicated before it is considered a standard approach to management.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0043-1776416","type":"journal-article","created":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T23:39:59Z","timestamp":1698881999000},"page":"e3065-e3073","source":"Crossref","is-referenced-by-count":7,"special_numbering":"S","title":["Intratracheal Instillation of Budesonide\u2013Surfactant for Prevention of Bronchopulmonary Dysplasia in Extremely Premature Infants"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4157-6148","authenticated-orcid":false,"given":"Kalsang","family":"Dolma","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, University of South Alabama, Mobile, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Zayek","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, University of South Alabama, Mobile, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aayushka","family":"Gurung","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, University of South Alabama, Mobile, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabien","family":"Eyal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, University of South Alabama, Mobile, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,11,1]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1542\/peds.2009-2959","article-title":"Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network","volume":"126","author":"B J Stoll","year":"2010","journal-title":"Pediatrics"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1378\/chest.11-1306","article-title":"General and respiratory health outcomes in adult survivors of bronchopulmonary dysplasia: a systematic review","volume":"141","author":"A Gough","year":"2012","journal-title":"Chest"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"F1","DOI":"10.1136\/fn.83.1.F1","article-title":"Early motor and mental development in very preterm infants with chronic lung disease","volume":"83","author":"M Katz-Salamon","year":"2000","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"07","key":"ref4","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1177\/000992289303200702","article-title":"Financial and emotional cost of bronchopulmonary dysplasia","volume":"32","author":"K A McAleese","year":"1993","journal-title":"Clin Pediatr (Phila)"},{"issue":"05","key":"ref5","first-page":"817","article-title":"Neonatal lung neutrophils and elastase\/proteinase inhibitor imbalance","volume":"130","author":"B E Ogden","year":"1984","journal-title":"Am Rev Respir Dis"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1016\/S0002-9378(97)70276-X","article-title":"Amniotic fluid cytokines (interleukin-6, tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-8) and the risk for the development of bronchopulmonary dysplasia","volume":"177","author":"B H Yoon","year":"1997","journal-title":"Am J Obstet Gynecol"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"F51","DOI":"10.1136\/fn.74.1.F51","article-title":"Inflammatory bronchopulmonary response of preterm infants with microbial colonisation of the airways at birth","volume":"74","author":"P Groneck","year":"1996","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"10","key":"ref8","first-page":"CD001146","article-title":"Early (&lt; 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