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BPD – postnatal steroids — RACP Paediatrics MCQ

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HardNeonatalBPD – postnatal steroidsRACP Paediatrics

A premature infant at 2 weeks of age is on mechanical ventilation and has failed multiple extubation attempts. Inflammatory markers are not elevated and infection has been excluded. What medication may be considered to facilitate extubation in the context of evolving BPD?

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Correct answer: B — Dexamethasone

Low-dose dexamethasone (e.g., DART protocol: 0.15 mg/kg/day tapering over 10 days) may be considered for ventilator-dependent preterm infants with evolving BPD to facilitate extubation. The benefits must be weighed against risks (short-term hyperglycaemia, hypertension, GI perforation; long-term neurodevelopmental concerns). Systemic steroids in the first week of life are NOT recommended.

Reference: RCH Melbourne – 2023 – BPD CPG; RACP Paediatric Curriculum – Neonatology