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Prevention and management of bronchopulmonary dysplasia: Lessons learned from the neonatal research network

Kathleen A Kennedy1, C Michael Cotten2, Kristi L Watterberg3

  • 1Department of Pediatrics, University of Texas Medical School at Houston, Houston, TX.

Seminars in Perinatology
|October 16, 2016
PubMed

Insights

Bronchopulmonary dysplasia (BPD) remains a significant challenge for extremely premature infants despite improved survival rates. While some treatments help survival, they haven't reduced BPD rates, highlighting the need for better strategies.

Area of Science:

  • Neonatal Medicine
  • Pediatric Respiratory Research

Background:

  • Extremely premature infants face high rates of bronchopulmonary dysplasia (BPD) despite advances in neonatal care.
  • Treatments improving survival, like antenatal steroids and surfactant replacement, have not decreased BPD incidence.
  • Interventions such as vitamin A and avoiding mechanical ventilation improve combined death/BPD outcomes but have limited impact on BPD alone.

Purpose of the Study:

  • To review the current challenges and therapeutic strategies for managing bronchopulmonary dysplasia (BPD) in extremely premature infants.
  • To evaluate the effectiveness of various interventions on BPD outcomes in neonatal medicine.

Main Methods:

  • Review of existing literature on neonatal respiratory support and BPD management.
  • Analysis of the impact of antenatal and postnatal interventions on BPD rates in premature infants.
  • Assessment of the role of postnatal steroids in BPD treatment.

Main Results:

  • Survival rates for extremely premature infants have improved, but the burden of BPD persists.
  • Antenatal steroids and surfactant replacement improve survival but not BPD rates.
  • Postnatal steroids show a beneficial effect on BPD, though optimal use is undetermined.
  • Vitamin A and avoidance of mechanical ventilation have modest effects on BPD alone.

Conclusions:

  • Bronchopulmonary dysplasia (BPD) remains a critical issue for extremely premature infants.
  • Further research is needed to determine optimal postnatal steroid regimens for BPD.
  • Developing effective strategies to reduce BPD in the most immature survivors is a priority for neonatal research networks.

Keywords:
Bronchopulmonary dysplasiaCorticosteroidsVentilation

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