The Use of Montelukast in Six Ventilator Dependent Infants
摘要
Background and aim: Bronchopulmonary dysplasia (BPD) results from severe acute lung injury in modestly premature newborns caused by the adverse effects of hyperoxia, inflammation, mechanical ventilation, or infection. There is currently no standard for BPD prevention or treatment. Montelukast (MK) is a selective antagonist of the leukotrienes D4 and is used to treat asthma and allergic rhinitis in children, as well as the prevention of adult asthma. Although having previously used MK to prevent BPD in 16 premature infants, no significant benefit was noted at that time. We described our experiences with using MK for decreasing ventilator support in infants who had difficulty being weaned from their ventilator usage. Methods: This study uses a retrospective review of the medical records of six infants admitted to our neonatal intensive care unit (NICU) from Dec. 2006 to Sept. 2008. All six cases were intubated for more than one week for different reasons and experienced difficulties being weaned from the ventilator. MK was used as the rescue therapy, with a dose of 2 mg per day. Results: The addition of MK was found to be associated with the improvement of clinical course within 10 days in five of the infants, the only exception being an infant with an extremely low birth weight. Because the addition of MK was closely related to clinical improvement in this study, further studies of the use of MK in the management of chronic lung diseases are warranted. Conclusion: Administration of MK to infants with severe lung parenchymal disease helps them to wean off ventilator support. (J Pediatr Resp Dis 2014;10:44-50)