[New concepts of corticosteroid treatment in pulmonary diseases of the premature infant].

Corticosteroids for treatment or prevention of pulmonary disease are milestones in the management of preterm infants nowadays. Prenatal maternal administration as well as postnatal treatment of the mechanically ventilated preterm infant with bronchopulmonary dysplasia (BPD) are considered to be established concepts. However, the side effects of systemically given corticosteroids can be considerable (e.g., increased mortality, which cannot be explained by a specific side effect). In order to avoid as many side effects as possible and to attain an optimal response determining the best regimen is under current investigation. This review describes new concepts of corticosteroid application from the last years which have focused on "pulse"-therapy, inhalative therapy and early administration of corticosteroids. In conclusion, the trend is using corticosteroids as a prophylaxis for BPD in preterm infants instead of as a consequent treatment.