The Minidex trial: does very low dose dexamethasone improve lung function in preterm infants?

The Minidex randomised controlled trial will assess the efficacy and safety of very low dose dexamethasone to facilitate the extubation of ventilator-dependent preterm infants who are at high risk of bronchopulmonary dysplasia (BPD). This article examines the controversy surrounding postnatal dexamethasone therapy and discusses how the information gathered in the Minidex trial will enable planning of a large pragmatic trial to determine dexamethasone’s effects on BPD and long-term neurodevelopmental outcomes.