Normally the adrenal glands release cortisol into the blood stream every morning. The brain monitors this amount and regulates the adrenal function. It cannot tell the difference between its own natural cortisone and that of steroid medicines. Therefore, when a person takes high doses of steroids over a long time, the brain may decrease or stop cortisol production. This is called adrenal suppression. Healthcare providers generally decrease a steroid dosage slowly to allow the adrenal gland to recover and produce cortisol at a normal level again. If you have been on steroids long-term do not stop taking them suddenly. Follow your doctor's prescription.
At 36 weeks postmenstrual age, 96% ( N = 1376) of the cohort survived with 313 discharges prior to 36 weeks. Oxygen requirement (moderate BPD as defined by Ehrenkranz et al  ) was noted in 34% (473) and 22% (316) required CPAP or mechanical ventilation (severe BPD  ). Inhaled steroids were administered to 12 (23%) of the 53 infants who died prior to 36 weeks. Of surviving infants, 43 (7%) with mild BPD (off oxygen or discharge at <36 weeks; N = 587), 68 (14%) with moderate BPD, and 47 (15%) with severe BPD received inhaled steroids at least once. Death occurred in 24 hospitalized infants after 36 weeks.
An associated editorial clothes the trial in noble purposes, suggesting (with an irony that's apparently unintentional) lower health care costs and reduced risks of pneumonia could result by "stepping down" ICS. These cheers don't quite ring true (payers negotiate down the prices for combination agents, often below that of the single agents; "stepped down" patients would still pay a copay, which may be the same; some believe ICS reduce the mortality from pneumonia while minutely increasing its incidence). Nowhere is the apparent strategic goal of the multi-million dollar trial alluded to.