Predicting Dexamethasone-Associated Extubation Success in Preterm Infants.

Objective: Dexamethasone improves respiratory status in some preterm infants with lung disease. Dexamethasone increases heart rate (HR) variability, which decreases the heart rate characteristics index (HRCi), a sepsis risk score that reflects inflammation. Respiratory improvement can be measured by the ability to wean support, quantified by a respiratory severity score (RSS). We hypothesized that HRCi and RSS early in dexamethasone treatment are associated with respiratory improvement marked by successful extubation. Study Design: We retrospectively reviewed neonatal intensive care unit (NICU) patients born at < 32 weeks gestational age (GA) admitted from 2012 to 2022 who received > 3 days of dexamethasone for lung disease while on mechanical ventilation. Daily mean FiO Results: A total of 65 infants (mean GA: 25 ± 1 weeks) were included. HRCi, FiO Conclusion: Dexamethasone treatment decreased the HRCi, but this was not associated with extubation success. Higher PMA and lower respiratory support were associated with successful extubation during dexamethasone treatment. Key Points: · Fifty-eight percent of preterm infants were successfully extubated during dexamethasone treatment.. · Higher PMA and lower RSS were associated with extubation success.. · HRCs improved with dexamethasone but did not predict extubation success..