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Intratracheal Budesonide and Bronchopulmonary Dysplasia in Extremely Preterm Infants—Reply
In Reply We thank the letter writers for their interest in the PLUSS trial, which was designed to determine if early prophylactic intratracheal budesonide mixed with surfactant would prevent BPD in infants born prior to 28 weeks’ gestation. Budesonide was not administered to treat or modify established preterm lung disease or evolving BPD, when treatment with systemic postnatal corticosteroids, such as dexamethasone, is typically considered. Prior to PLUSS, Yeh et al reported that early intratracheal budesonide, 0.25 mg/kg (the same dose used in PLUSS), resulted in a large reduction in the risk of death or BPD. As discussed in our article, it remains unclear why early intratracheal budesonide had little to no effect on survival without BPD in PLUSS.
In Reply We thank the letter writers for their interest in the PLUSS trial, which was designed to determine if early prophylactic intratracheal budesonide mixed with surfactant would prevent BPD in infants born prior to 28 weeks’ gestation. Budesonide was not administered to treat or modify established preterm lung disease or evolving BPD, when treatment with systemic postnatal corticosteroids, such as dexamethasone, is typically considered. Prior to PLUSS, Yeh et al reported that early intratracheal budesonide, 0.25 mg/kg (the same dose used in PLUSS), resulted in a large reduction in the risk of death or BPD. As discussed in our article, it remains unclear why early intratracheal budesonide had little to no effect on survival without BPD in PLUSS.
