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The preterm lung and airway: past, present, and future

Richard J Martin1, Avroy A Fanaroff

  • 1Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA. rxm6@case.edu

Pediatrics and Neonatology
|April 20, 2013
PubMed

Insights

Neonatal intensive care has improved survival from respiratory distress syndrome, but bronchopulmonary dysplasia (BPD) remains a challenge. Research now focuses on minimizing lung injury during birth and understanding long-term respiratory issues like asthma in preterm infants.

Area of Science:

  • Neonatology
  • Pulmonology
  • Developmental Biology

Background:

  • Advances in neonatal intensive care have improved survival rates for newborns with respiratory distress syndrome over the past 40-50 years.
  • Improved survival has unfortunately been linked to increased long-term morbidity, specifically bronchopulmonary dysplasia (BPD).
  • Neonatal lung injury is a significant area of ongoing scientific investigation.

Purpose of the Study:

  • To explore the origins of neonatal lung injury, potentially starting in the delivery room.
  • To investigate strategies for minimizing oxygen therapy and aggressive ventilation during the fetal-to-neonatal transition.
  • To understand the epidemiology and pathogenesis of persistent respiratory morbidities, such as asthma, in preterm survivors.

Main Methods:

  • Review of current therapeutic approaches for BPD.
  • Analysis of the pro-inflammatory components contributing to BPD.
  • Epidemiological and pathogenetic studies on long-term respiratory outcomes in preterm infants.

Main Results:

  • Antenatal steroid therapy and selective surfactant therapy are established practices, with ongoing refinement for specific populations.
  • Emerging therapies target various aspects of BPD, including its inflammatory pathways.
  • There is a recognized need for deeper understanding of the long-term respiratory health of infants who survive neonatal intensive care.

Conclusions:

  • While neonatal care has advanced, bronchopulmonary dysplasia (BPD) remains a critical concern.
  • Minimizing initial lung injury and developing targeted therapies are key to improving outcomes.
  • Further research into the long-term respiratory health, including asthma, of preterm survivors is essential.

Keywords:
bronchopulmonary dysplasianeonatal lung injuryneonatal respiratory therapy

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