***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: We previously reported on a 7-day course of dexamethasone starting at 0.5 mg/kg/day in intubated very low birth weight ( VLBW ) infants , 7 - 14 days of age , with increased dynamic pulmonary compliance and decreased bronchopulmonary dysplasia ( BPD ) . The effect of low-dose dexamethasone on functional residual capacity ( FRC ) in VLBW infants is unknown . The objective of this study was to compare the effect of two regimens of moderately early dexamethasone on FRC and passive respiratory compliance ( Crs ) in VLBW infants at risk for BPD . Sixty-two intubated VLBW infants were r and omized ( double-blinded ) at 7 - 21 days of age ; 29 patients ( mean birth weight , 839 g ) received " high " dose dexamethasone ( 0.5 mg/kg/day for 3 days , 0.25 mg/kg/day for 3 days , and 0.1 mg/kg/day on day 7 , total dose of 2.35 mg/kg ) , and 33 infants ( mean birth weight , 830 g ) received " low-dose " dexamethasone ( 0.2 mg/kg/day for 3 days and 0.1 mg/kg/day for 4 days , total dose of 1 mg/kg ) . FRC and Crs were measured with the nitrogen washout technique and single breath occlusion technique , before and on days 2 , 5 , and 7 of therapy . Clinical outcome and early neurodevelopmental follow-up were evaluated . FRC significantly increased in the high-dose ( 19.3 ml/kg at baseline to 34 ml/kg on day 7 ; P < 0.001 ) and low-dose ( 18.1 ml/kg at baseline to 30.3 ml/kg on day 7 ; P < 0.001 ) dexamethasone groups when compared to baseline . There was a significant increase in Crs and a decrease in FiO2 within each group . The improvements in FRC and Crs were comparable between groups , and specific compliances ( Crs/FRC ) were not different . There were no significant differences in other clinical outcome parameters , including BPD and neurodevelopmental outcome . In conclusion , there are significant increases in FRC during a 7-day course of moderately early dexamethasone in VLBW infants . The lower total dose ( 1 mg/kg ) appears as effective as the higher total dose of dexamethasone ( 2.35 mg/kg ) in increasing FRC . Comparable significant increases in Crs were observed in both groups of infants . Additional long-term follow-up is underway In a multicenter trial of steroid therapy for chronic neonatal oxygen dependence , 287 neonates were r and omly allocated from around 3 weeks of age , to dexamethasone or placebo . Active treatment significantly reduced the duration of further assisted ventilation among infants who were ventilator dependent at entry ( median days for survivors , 11 vs 17.5 ) . There were no statistically significant differences between the total groups of survivors in time receiving supplemental oxygen and length of stay in hospital , although the trend favored the dexamethasone group . Twenty-five infants in each group died prior to hospital discharge ; most were ventilator dependent at trial entry . Open treatment with steroids was later given to 18 % in the active group and to 43 % in the placebo group . There was no evidence of serious side effects ; in particular , infection rates were similar in the two groups OBJECTIVE To compare duration of ventilation to mortality and adverse neurodevelopmental outcomes among extremely low birth weight ( ELBW ; 501 - 1000 g ) infants . STUDY DESIGN Retrospective analysis of prospect ively collected data from 5364 infants with a birthweight of 501 to 1000 g born at National Institute of Child Health and Human Development ( NICHD ) Neonatal Research Network centers from 1995 to 1998 . The main outcome measures were : survival , duration of mechanical ventilation , and neurodevelopmental outcome . RESULTS Overall survival was 71 % . The median duration of ventilation for survivors was 23 days ; 75 % were free of mechanical ventilation by 39 days , and 7 % were ventilated for > or = 60 days . Of those ventilated for > or = 60 days , 24 % survived without impairment . Of those ventilated for > or = 90 days , only 7 % survived without impairment . Of those ventilated > or = 120 days , all survivors were impaired . CONCLUSIONS The prognosis for ELBW with protracted ventilation remains grim . The cohort who remain intubated have diminished survival and high rates of impairment . Parents of these infants should be informed of changes in prognosis as the time of ventilation increases Two historical cohorts ( 1993–1994 and 2001 ) of preterm infants ventilated for respiratory distress syndrome were compared .  Dexamethasone administration fell from 22 % to 6 % . Chronic lung disease in survivors rose slightly from 13 % to 17 % , and mortality fell from 21 % to 15 % ( other causes ) . The effect of restriction of dexamethasone use on chronic lung disease and mortality remains to be seen A r and omized trial was conducted of dexamethasone therapy in infants with bronchopulmonary dysplasia who were dependent on respirators and were not progressing clinical ly despite conventional treatment . Babies were admitted to the study if they had a roentgenogram and clinical diagnosis of bronchopulmonary dysplasia , were 2 to 6 weeks in age , weighed less than 1,500 g , had made no progress in weaning for the preceding five days , and were free of sepsis , patent ductus arteriosus , and congenital heart disease , and had had no intravenous fat for at least 24 hours . After parental consent was obtained , infants were r and omly assigned to control or treatment groups . The study hypothesis was that with steroid treatment , babies could be weaned from the respirator within 72 hours and would show a significant improvement in lung compliance within that time . Sequential analysis exceeded criterion ( P less than .05 ) when seven consecutive untied pairs showed weaning with dexamethasone and failure to wean in control infants . Pulmonary compliance improved by 64 % in the treated group and 5 % in the control group ( P less than .01 ) . No significant intergroup differences were noted in mortality , length of hospital stay , sepsis , hypertension , hyperglycemia , or electrolyte abnormalities . Study design permits the conclusion that dexamethasone can produce substantial short-term improvement in lung function , often permitting rapid weaning from the respirator , but long-term efficacy and safety must be demonstrated by further investigations OBJECTIVE . Low-dose dexamethasone facilitates extubation in chronically ventilator-dependent infants with no obvious short-term complications . The objective of this study was to determine the long-term effects of low-dose dexamethasone . METHODS . Very preterm ( < 28 weeks ' gestation ) or extremely low birth weight ( birth weight < 1000 g ) infants who were ventilator dependent after the first week of life for whom clinicians considered corticosteroids were indicated were eligible . After informed consent , infants were r and omly assigned to masked dexamethasone ( 0.89 mg/kg over 10 days ) or saline placebo . Survivors were assessed at 2 years ' corrected age by staff blinded to treatment group allocation to determine neurosensory outcome , growth , and health . RESULTS . The trial was ab and oned well short of its target sample size because of recruitment difficulties . Seventy infants were recruited from 11 centers , 35 in each group : 59 survived to 2 years of age , and 58 ( 98 % ) were assessed at follow-up , but data for cerebral palsy were available for only 56 survivors . There was little evidence for a difference in the major end point , the rate of the combined outcome of death , or major disability at 2 years of age  ( dexamethasone group : 46 % ; controls : 43 % ) . Rates of mortality before follow-up ( 11 % vs 20 % ) , major disability ( 41 % vs 31 % ) , cerebral palsy ( 14 % vs 22 % ) , or of the combined outcomes of death or cerebral palsy ( 23 % vs 37 % ) were not substantially different between the groups . There were no obvious effects of low-dose dexamethasone on growth or readmissions to hospital after discharge . CONCLUSIONS . Although this trial was not able to provide definitive evidence on the long-term effects of low-dose dexamethasone after the first week of life in chronically ventilator-dependent infants , our data indicate no strong association with long-term morbidity Objective . To evaluate the effectiveness of nebulized pentoxifylline ( PTXF ) compared to intravenous dexamethasone ( DX ) or placebo ( nebulized distilled water ) for the prevention of  bronchopulmonary dysplasia ( BPD ) .  Methods . One hundred and fifty very low birth weight infants were r and omly assigned to three groups . Entry criteria were the need for oxygen administration on the fourth day of life , irrespective of whether ventilatory support was required . PTXF was administered with a nebulizer every 6 hours on three consecutive days ( a single course ) in a dose of 20 mg/kg when infants were breathing spontaneously or 10 mg/kg when they needed ventilatory support . DX was given every 12 hours on three consecutive days in a dose of 0.25 mg/kg . Nebulized distilled water was administered with the schedule of inhalation as in the PTXF group . When the need for ventilatory support or oxygen dependency persisted , the course of both drugs and placebo administration was repeated every seven days until the diagnosis of BPD was established . Results . Both PTXF and DX reduced the incidence of disease when compared with placebo . The respective data obtained for the PTXF-group versus the placebo group were as follows : difference in risk , 27 % ; OR : 0.32 ; CI : 0.11–0.94 ; p = 0.039 ; whereas the results for the DX-group versus the placebo group were : difference in risk , − 23 % ; OR : 0.39 ; CI : 0.14–1.14 ; p = 0.07 . Conclusion . Our data show that nebulized PTXF  reduces the risk of BPD  and may be a potential alternative to steroids in the prevention of this disease In order to assess the efficacy of a combination of systemic and nebulized corticosteroids in reducing the incidence and severity of chronic lung disease ( CLD ) in very low birthweight ( VLBW ) infants , 60 ventilator‐dependent infants ≤ 1500 g were r and omly assigned to receive either steroids or placebo as of 7d . The steroid group ( n= 30 , GA = 25:8 ± 1:6 weeks , BW = 731 ± 147 g ) received systemic dexamethasone for 3 d , followed by nebulized budesonide for 18 d. Control infants ( n= 30 , GA = 25:9 ± 1.8 weeks , BW = 796 ± 199 g ) received systemic and inhaled saline . Steroid‐treated infants required less ventilatory support between 9 and 17 d ( p < 0:01 ) , and had greater lung compliance at 10 d ( p= 0:01 ) , but not subsequently . CLD incidence at 36 weeks was 45.5 % vs 56.0 % in controls , and fewer steroid‐treated infants required dexamethasone rescue ( 23.3 % vs 56.7 % , p= 0:017 ) . Survival to discharge was similar ( 73.3 % vs 83.3 % ) , as were the duration s of mechanical ventilation , supplemental oxygen use , and hospitalization . Tracheal effluent elastase/albumin ratios and serum cortisol values did not differ between groups , and no adverse effects were noted . We conclude that early dexamethasone administration was associated with improved pulmonary function , which was not sustained with nebulized budesonide . However , the steroid regimen studied reduced the need for dexamethasone rescue in infants with CLD Background . Infection is a major complication of preterm infants , result ing in increased morbidity and mortality . We recently reported the results of a multicenter trial of dexamethasone initiated at 14 or 28 days in very low birth weight ( VLBW ) infants who were at risk for chronic lung disease ; the results showed an increase in nosocomial bacteremia in the group receiving dexamethasone . This study is an in-depth analysis of bacteremia/sepsis and meningitis among infants enrolled in the trial . Methods . Data on cultures performed and antibiotic therapy were collected prospect ively . Infections were classified as definite or possible/ clinical . Results . A total of 371 infants were enrolled in the trial . There were no baseline differences in risk factors for infection . For the first 14 days of study , infants received either dexamethasone ( group I , 182 ) or placebo ( group II , 189 ) . During this period , infants in group I were significantly 
    Output:
    
Higher cumulative dexamethasone doses administered after the first week of life may decrease the risk for bronchopulmonary dysplasia without increasing the risk for neurodevelopmental sequelae in ventilated preterm infants .