Abstract
Postnatal steroids are a controversial intervention for the prevention and treatment of bronchopulmonary dysplasia in preterm infants. Studies demonstrating a potential for steroid-related adverse effects, including growth and neurodevelopmental impairment, have significantly changed clinical practice over the past decade. There are circumstances in which the potential benefits may outweigh the risks associated with postnatal steroids. This case presentation details the hospital course and treatment plan for an extremely low-birth-weight infant who remained ventilator dependent at the age of 3 weeks. Evidence-based research, American Academy of Pediatric recommendations, and collaboration with the family helped guide the plan of care. Following a short course of low-dose dexamethasone, the infant was successfully extubated. The case highlights the importance of using clinical judgment based on research and family preferences to benefit the patient.