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Current strategies for treating infants with severe bronchopulmonary dysplasia

Paola Papoff1, Carla Cerasaro, Elena Caresta

  • 1Department of Paediatrics, Paediatric Emergency and Intensive Care, Sapienza University of Rome, Rome, Italy. p.papoff@libero.it

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|September 29, 2012
PubMed

Insights

Advances in neonatal care improve survival for extremely premature infants. However, "new" bronchopulmonary dysplasia (BPD) can arise, requiring careful management of oxygen and ventilation to support lung growth.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Respiratory Physiology

Background:

  • Neonatal intensive care advances improve survival for infants born before 26 weeks gestation.
  • Premature infants are susceptible to "new" bronchopulmonary dysplasia (BPD) due to lung development disruption from oxygen and ventilation.
  • Severe BPD often requires prolonged respiratory support, with limited curative treatments.

Purpose of the Study:

  • To review current management strategies for "new" bronchopulmonary dysplasia in premature infants.
  • To highlight the importance of maintaining gas exchange and promoting lung growth in severe BPD.
  • To discuss pharmacological interventions for complications like pulmonary hypertension.

Main Methods:

  • Review of current literature on neonatal respiratory support and BPD management.
  • Analysis of treatment approaches for severe BPD, including ventilation and oxygen therapy.
  • Examination of pharmacological interventions such as corticosteroids and pulmonary vasodilators.

Main Results:

  • Most BPD cases are mild, but severe forms necessitate ongoing ventilator and oxygen support.
  • Short-course, low-dose corticosteroids can improve lung function and facilitate weaning from respiratory support.
  • Pulmonary hypertension is a significant complication, potentially managed with vasodilators like sildenafil and bosentan.

Conclusions:

  • Management of severe BPD focuses on optimizing gas exchange and lung growth.
  • Corticosteroids and pulmonary vasodilators show promise in improving outcomes for premature infants with BPD.
  • Further research is needed for definitive treatments for severe "new" BPD.

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