{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T02:56:11Z","timestamp":1790996171871,"version":"4.1.0"},"reference-count":15,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neonatal-Perinatal Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bronchopulmonary dysplasia (BPD) remains a major cause of morbidity among preterm infants with respiratory distress syndrome (RDS). Intratracheal budesonide combined with surfactant may reduce pulmonary inflammation and improve neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this randomized clinical trial, 160 preterm infants (gestational age 26\u201332 weeks; birth weight &lt;1500\u00a0g) requiring surfactant therapy for RDS were assigned to receive either surfactant alone (n = 80) or surfactant plus budesonide (0.25\u00a0mg\/kg;\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 80). Primary outcomes were oxygen dependency or respiratory support beyond 21\u00a0days of life (the prespecified study respiratory outcome) and in-hospital mortality. Secondary outcomes included sepsis, intraventricular hemorrhage, necrotizing enterocolitis, retinopathy of prematurity, respiratory support duration, and repeat surfactant administration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were comparable between groups. The primary respiratory outcome occurred in 16\/80 infants (20.0%) in the budesonide-surfactant group and 26\/80 infants (32.5%) in the surfactant-alone group (absolute risk difference \u221212.5 percentage points;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.105). Mortality was significantly lower in the combination group (1.2% vs 11.2%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.018), as was culture-proven sepsis (5.0% vs 21.2%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004). Infants receiving budesonide required fewer repeat surfactant doses (38.8% vs 61.3%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.016) and had a shorter duration of nasal continuous positive airway pressure support (10.1 \u00b1 6.0 vs 17.9 \u00b1 11.3\u00a0days,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001). The composite outcome of death or oxygen dependency\/respiratory support beyond 21\u00a0days of life occurred in 35 infants (43.8%) in the control group and 17 infants (21.3%) in the combination group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In preterm infants with RDS, budesonide-surfactant therapy was associated with reduced mortality, sepsis, respiratory support duration, and repeat surfactant use. Although fewer infants in the intervention group met the prespecified respiratory outcome, the difference was not statistically significant. Larger multicenter trials using contemporary BPD definitions and incorporating long-term neurodevelopmental follow-up are needed before efficacy and safety can be established.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19345798261490894","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:00:21Z","timestamp":1790665221000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Intratracheal budesonide combined with surfactant for respiratory distress syndrome in preterm infants: A randomized clinical trial"],"prefix":"10.1177","author":[{"given":"Mohammad Kazem","family":"Sabzehei","sequence":"first","affiliation":[{"name":"Hamadan University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanieh","family":"Talebi","sequence":"additional","affiliation":[{"name":"Hamadan University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behnaz","family":"Basiri","sequence":"additional","affiliation":[{"name":"Hamadan University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Shokouhi Solgi","sequence":"additional","affiliation":[{"name":"Hamadan University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roya","family":"Raeisi","sequence":"additional","affiliation":[{"name":"Hamadan University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Jafarvand","sequence":"additional","affiliation":[{"name":"Hamadan University of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_3_5_2_2","volume-title":"Born too soon: decade of action on preterm birth","author":"World Health Organization","year":"2023","unstructured":"World Health Organization. Born too soon: decade of action on preterm birth. WHO, 2023."},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2018.12.008"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0312561"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.17380"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2025.1518957"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12134207"},{"key":"e_1_3_5_8_2","first-page":"L671","article-title":"Moving bronchopulmonary dysplasia research from the bedside to the bench","volume":"323","author":"Gilfillan M","year":"2022","unstructured":"Gilfillan M, Bhandari V. Moving bronchopulmonary dysplasia research from the bedside to the bench. Am J Physiol Lung Cell Mol Physiol 2022; 323: L671\u2013L680.","journal-title":"Am J Physiol Lung Cell Mol Physiol"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2015-309943"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.21037\/tp-22-8"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.24953\/turkjped.2020.04.004"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-024-04736-9"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201505-0861OC"},{"key":"e_1_3_5_14_2","first-page":"1217","article-title":"Intratracheal administration of budesonide with surfactant in very low birth weight infants to prevent bronchopulmonary dysplasia","volume":"30","author":"Shehab MM","year":"2024","unstructured":"Shehab MM, Elhassanein Elkhawaga ES, Elsayed LM, et al. Intratracheal administration of budesonide with surfactant in very low birth weight infants to prevent bronchopulmonary dysplasia. Zagazig Univ Med J 2024; 30: 1217\u20131225.","journal-title":"Zagazig Univ Med J"},{"key":"e_1_3_5_15_2","first-page":"137","article-title":"Clinical efficacy of pulmonary surfactant combined with budesonide for preventing bronchopulmonary dysplasia in very low birth weight infants","volume":"19","author":"Pan J","year":"2017","unstructured":"Pan J, Chen M-W, Ni W-Q, et al. Clinical efficacy of pulmonary surfactant combined with budesonide for preventing bronchopulmonary dysplasia in very low birth weight infants. Zhongguo Dang Dai Er Ke Za Zhi 2017; 19: 137\u2013141.","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-019-0663-6"}],"container-title":["Journal of Neonatal-Perinatal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19345798261490894","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19345798261490894","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19345798261490894","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T02:16:26Z","timestamp":1790993786000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19345798261490894"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":15,"alternative-id":["10.1177\/19345798261490894"],"URL":"https:\/\/doi.org\/10.1177\/19345798261490894","relation":{},"ISSN":["1934-5798","1878-4429"],"issn-type":[{"value":"1934-5798","type":"print"},{"value":"1878-4429","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"article-number":"19345798261490894"}}