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Bronchopulmonary Dysplasia (BPD)NCT07904104

Late Low-Dose Dexamethasone in Preterm Neonates Using DART Protocol

A study testing Dexamethasone in people with Bronchopulmonary Dysplasia (BPD), run by Shaheed Zulfiqar Ali Bhutto Medical University at 1 site in Pakistan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Premature babies, especially those who need breathing support for many days, are at risk of developing a long-term lung condition called bronchopulmonary dysplasia (BPD). BPD usually means that the baby still needs oxygen or breathing support around 36 weeks' postmenstrual age. Read more about this study

Who is it for?
Ages 8 days and older
Conditions the study is for
Bronchopulmonary Dysplasia (BPD)
What is being tested?
Dexamethasone
Could I receive a placebo?
No, everyone receives an active treatment
How many people
93 participants
Where
1 sitePakistan
Study dates
18 Jun 2025to 15 Nov 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 8 days and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Gestational age at birth of 28-36 weeks.
  • Birth weight below 2,000 grams.
  • Postnatal age greater than seven days and postmenstrual age below 36 weeks at enrolment.
  • Ongoing requirement for invasive and/or non-invasive ventilation with a fraction of inspired oxygen of at least 0.30.
  • No meaningful reduction in respiratory support during the preceding 72 hours.
  • Written informed consent from a parent or legal guardian.

Who cannot join

  • Haemodynamically significant patent ductus arteriosus.
  • Air-leak syndromes.
  • Congenital malformations.
  • Genetic or metabolic disorders.
  • Previous exposure to postnatal corticosteroids.
  • Necrotising enterocolitis.
  • Focal intestinal perforation.
  • Severe intraventricular haemorrhage on cranial ultrasonography.

Trial locations and contacts

1 site in 1 country.

Pakistan1 site
  • Children's Hospital, Pakistan Institute of Medical Sciences

    Islamabad, Islamabad, 44000

Other trials in Pakistan

About this study

Official title: Effect of Late (>7 Days) Low-Dose Dexamethasone on Ventilated Preterm Neonates to Prevent Bronchopulmonary Dysplasia: A Quasi-experimental Study

Premature babies, especially those who need breathing support for many days, are at risk of developing a long-term lung condition called bronchopulmonary dysplasia (BPD). BPD usually means that the baby still needs oxygen or breathing support around 36 weeks' postmenstrual age. This condition can make recovery longer and may affect the baby's breathing and development later in life.

This study looked at whether a low dose of dexamethasone, a steroid medicine that reduces inflammation, could help premature babies who were still dependent on a ventilator or non-invasive breathing support after the first week of life. The medicine was given using the DART protocol, which is a short, low-dose course of dexamethasone designed to help babies come off breathing support while reducing the risk of side effects.

Read more

The study was conducted in the Neonatal Intensive Care Unit (NICU) at the Children's Hospital, Pakistan Institute of Medical Sciences (PIMS), Islamabad. A total of 93 premature babies were included. All babies were more than 7 days old, born between 28 and 36 weeks of pregnancy, weighed less than 2000 grams at birth, and still needed significant breathing support. Babies with certain serious conditions, such as major congenital abnormalities, severe intestinal disease, or previous steroid exposure, were not included.

Investigators recorded each baby's oxygen requirement and ventilator pressure before and during dexamethasone treatment. They also observed whether the baby could be successfully removed from the ventilator within 10 days, how long oxygen and breathing support were needed, and whether any side effects occurred.

After treatment, babies needed less oxygen and lower ventilator pressure. The oxygen requirement decreased from 0.56 to 0.33, and mean airway pressure decreased from 12.3 to 8.9 cmH₂O. Seventy out of 93 babies, or 75.3%, were successfully extubated within 10 days. At 36 weeks' postmenstrual age, 26.9% of babies met the criteria for BPD.

The short-term side effects were manageable. Eleven babies developed temporary high blood sugar, and six developed high blood pressure; both were treated medically. No gastrointestinal perforation or steroid-related death was observed.

This study suggests that late, low-dose dexamethasone may help selected premature babies reduce breathing support and come off the ventilator earlier. However, because this was a single-arm study without a comparison group, it cannot prove that dexamethasone prevents BPD. Larger controlled studies with long-term follow-up are needed to confirm the benefits and safety of this treatment.

Read the detailed description

Bronchopulmonary dysplasia (BPD) is an important complication of prematurity, particularly among preterm neonates who require prolonged invasive or non-invasive ventilatory support. Persistent lung inflammation, oxygen exposure, and ventilator-associated injury contribute to evolving chronic lung disease in this population. Low-dose systemic dexamethasone has been used in selected ventilator-dependent preterm infants to reduce pulmonary inflammation and support weaning from respiratory support.

This study evaluated late low-dose dexamethasone administered after the first postnatal week using the Dexamethasone-Aided Respiratory Therapy (DART) protocol in ventilated preterm neonates admitted to a tertiary neonatal intensive care unit in Pakistan. The study focused on clinically relevant respiratory response during treatment, including changes in ventilatory requirements and extubation status, as well as short-term safety events and BPD status at 36 weeks' postmenstrual age. The study was designed to provide local evidence on the feasibility and clinical response associated with a standardized low-dose dexamethasone protocol in a resource-limited neonatal care setting.

Being tested
Dexamethasone
Keywords
Bronchopulmonary Dysplasia, Dexamethasone, Anti-Inflammatory Agent, DART Protocol, Infant, Premature
Medical subject headings
Bronchopulmonary Dysplasia, Premature Birth

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • DexamethasoneDrug

    Systemic dexamethasone was administered parenterally according to the DART protocol: 0.075 mg/kg per dose every 12 hours on days 1-3, 0.05 mg/kg per dose every 12 hours on days 4-6, 0.025 mg/kg per dose every 12 hours on days 7-8, and 0.01 mg/kg per dose every 12 hours on days 9-10. The planned cumulative dose was 0.89 mg/kg over 10 days. Treatment was discontinued if pulmonary haemorrhage or newly detected or worsening intraventricular haemorrhage occurred.

Study groups in NCT07904104
Study groupRoleWhat they receive
Late Low-dose DexamethasoneExperimentalPreterm neonates requiring ongoing invasive and/or non-invasive ventilation received systemic low-dose dexamethasone after the first seven days of postnatal life. Treatment was administered using a tapering regimen for up to 10 days. Respiratory support requirements, extubation, complications during treatment, and bronchopulmonary dysplasia status at 36 weeks' postmenstrual age were assessed.
Receives: Drug: Dexamethasone

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Fraction of Inspired Oxygen (FiO₂)

    Change in the fraction of inspired oxygen required for respiratory support from baseline before dexamethasone initiation to treatment day 10. FiO₂ is expressed as a fraction from 0.21 to 1.00. A lower value indicates a lower supplemental oxygen requirement.

    Measured: Baseline before the first dexamethasone dose and day 10 after treatment initiation.

  2. Change in Mean Airway Pressure

    Change in mean airway pressure, measured in cmH₂O, from baseline before dexamethasone initiation to treatment day 10. A lower value indicates a reduction in the airway pressure used for respiratory support.

    Measured: Baseline before the first dexamethasone dose and day 10 after treatment initiation.

  3. Successful Extubation Within 10 Days

    Number of infants successfully extubated from invasive mechanical ventilation within 10 days after dexamethasone initiation.

    Measured: Within 10 days after the first dexamethasone dose.

  4. Time to Successful Extubation

    Time in days from the first dexamethasone dose to successful extubation from invasive mechanical ventilation.

    Measured: From dexamethasone initiation through day 10.

  5. Total Duration of Ventilatory Support

    Total number of days during which an infant received invasive mechanical ventilation and/or non-invasive ventilation.

    Measured: 20 days

  6. Total Duration of Supplemental Oxygen Therapy

    Total number of days during which an infant received supplemental oxygen.

    Measured: 20 days

  7. Pulmonary Haemorrhage During Treatment

    Number of infants who developed pulmonary haemorrhage during dexamethasone treatment.

    Measured: From the first dexamethasone dose until treatment discontinuation or completion, up to 10 days.

  8. Intraventricular Haemorrhage During Treatment

    Number of infants with newly detected or worsening intraventricular haemorrhage during dexamethasone treatment, assessed using cranial ultrasonography.

    Measured: From the first dexamethasone dose until treatment discontinuation or completion, up to 10 days.

  9. All-cause Mortality During Treatment

    Number of infants who died from any cause during the dexamethasone treatment period.

    Measured: From the first dexamethasone dose through day 10.

Secondary outcomes (1)
  1. Bronchopulmonary Dysplasia Status and Severity

    Number of infants in each bronchopulmonary dysplasia category: no bronchopulmonary dysplasia, mild, moderate, or severe, classified using the National Institutes of Health criteria specified in the study protocol.

    Measured: At 36 weeks' postmenstrual age.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Oct 2026
  2. Study start18 Jun 2025
  3. Primary completion19 Sep 2025
  4. Study completion15 Nov 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Model description
Single-arm, Quasi-experimental interventional study
Masking
None (open label)
Enrolment
93 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07904104
Sponsor's protocol ID
F.1-1/2015/ERB/SZABMU/1434
Status last verified
Oct 2026
First submitted
21 Oct 2026
Last updated
29 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: De-identified individual participant data underlying the published results will be available from the corresponding author upon reasonable request for scientifically sound research. Requests will be reviewed for scientific merit and consistency with participant consent and institutional ethics requirements. Access will be subject to institutional approval and, where required, a data-sharing agreement. Direct identifiers will not be shared.

Publications

  • van de Loo M, van Kaam A, Offringa M, Doyle LW, Cooper C, Onland W. Corticosteroids for the prevention and treatment of bronchopulmonary dysplasia: an overview of systematic reviews. Cochrane Database Syst Rev. 2024 Apr 10;4(4):CD013271. doi: 10.1002/14651858.CD013271.pub2.

    PubMed 38597338
  • Ramaswamy VV, Bandyopadhyay T, Nanda D, Bandiya P, Ahmed J, Garg A, Roehr CC, Nangia S. Assessment of Postnatal Corticosteroids for the Prevention of Bronchopulmonary Dysplasia in Preterm Neonates: A Systematic Review and Network Meta-analysis. JAMA Pediatr. 2021 Jun 1;175(6):e206826. doi: 10.1001/jamapediatrics.2020.6826. Epub 2021 Jun 7.

    PubMed 33720274
  • Jensen EA, Watterberg KL. Postnatal Corticosteroids To Prevent Bronchopulmonary Dysplasia. Neoreviews. 2023 Nov 1;24(11):e691-e703. doi: 10.1542/neo.24-11-e691.

    PubMed 37907402
  • Doyle LW. Postnatal Corticosteroids to Prevent or Treat Bronchopulmonary Dysplasia. Neonatology. 2021;118(2):244-251. doi: 10.1159/000515950. Epub 2021 May 11.

    PubMed 33975319
  • Qudrat SM, Riaz S, Allah NUM, Razzaq S, Akhtar HN, Jahanzaib M. Effect of Late (>7 Days) Low-dose Dexamethasone on Ventilated Preterm Neonates to Prevent Bronchopulmonary Dysplasia: A Quasi-experimental Study. Journal of Rawalpindi Medical College. 2026 Jun. 30;30(2):359-65. Available from: https://journalrmc.com/index.php/JRMC/article/view/3159

Questions about this trial

What is this clinical trial studying?

A study testing Dexamethasone in people with Bronchopulmonary Dysplasia (BPD), run by Shaheed Zulfiqar Ali Bhutto Medical University at 1 site in Pakistan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 29 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Fraction of Inspired Oxygen (FiO₂) (time frame: Baseline before the first dexamethasone dose and day 10 after treatment initiation.). The study lists 9 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07904104, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Oct 2026.

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