Postnatal Steroids usage for bronchopulmonary dysplasia in a quaternary care NICU.

184 infants (8% of < 33 week infants) received PNS. The median (IQR) gestational age and birth weight were 25 (24-26) weeks and 720 (625-841) grams, respectively. The median (IQR) day of initiation and duration of PNS use were 29 (19-38) and 10 (10-22) days, respectively. 157 (85%) infants received dexamethasone (DX) and 22 (12%) received hydrocortisone (HC) as the first PNS course, and 71 (39%) infants received multiple courses. The proportion of infants receiving PNS remained unchanged, but the cumulative median dose received for BPD per patient increased by 56%. Nearly one third of cumulative PNS dose came from PNS used for non-BPD indications. 46% infants had a deviation from published regimen (±20% in duration or ±10% dose). Survival, survival without major morbidity, moderate-to-severe BPD and technology dependence at discharge were 87%, 2%, 91% and 67% respectively. Conclusion Increased variation in PNS use, deviation from published regimen, and concurrent PNS exposure from non-BPD indication offer insights for implementing interventions to improve processes.