Hi 99ers,

Do you regularly use Budesonide nebs in the preterm population? If so what guides your use  ( FiO2, mode of support, CXR changes ) and if so what is the length of the course (days or weeks). Not sure the evidence is there but it is becoming more prevalent.

Thanks, have a good weekend 👍

Ali

Not regularly any longer. (I am also non-believer after the Neurosis trial)

But sometimes, someone (not me!) starts inhalations, I'd say typically at ~32 weeks post-conceptionally if BPD-development is more complicated ("higher" FiO2 [I'd say >50% and increasing] and "higher" CPAP-pressure dependency). We have guideline about this though.

Yes. BPD 

We use it regularly starting around 27wks cga or at 2 weeks of life to help facilitate weaning. We start at 0.25mg BID and increase to 0.5mg if needed. We have wonderful BPD rates. We use this along with Diruil- we haven’t trached for BPD in many many years! 

I do in early BPD >

 

Hello group, someone has it protocolized, could you upload it, or comment on how you do it, nebulize puff dose, time. A local treatment rather than a systemic one proposed by DART would seem interesting.

Many thanks for all your responses, wide variation in approaches. 👍

Ali

A common and significant problem is the actual delivered dosage. There are too many variables to effectively standardize treatment.

No evidence, but some people use it to wean off from o2

I don't believe it's effective, and there's no evidence to support it. Therefore, I choose not to prescribe it. 

RT here...Inhaled corticosteroids in general yes. We only nebulize via ultrasonic neb via our HFOV but on our population that has a lingering O2 demand I feel we have success with Flovent BID via spacer/mask. I was a longtime non-believer but over the last 10 or so years I've been convinced it helps us wean quicker. I've never seen ADR, its quick and easy.