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Surfactant, steroids and non-invasive ventilation in the prevention of BPD

Vikramaditya Dumpa1, Vineet Bhandari2

  • 1Division of Neonatology, Department of Pediatrics, NYU Winthrop Hospital, 259 First Street, Mineola, NY 11501, United States.

Seminars in Perinatology
|October 23, 2018
PubMed

Insights

Preventing bronchopulmonary dysplasia (BPD) in premature infants focuses on reducing lung injury from ventilation and inflammation. Recent advances include improved surfactant treatments and non-invasive respiratory support strategies.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Critical Care Medicine

Background:

  • Bronchopulmonary dysplasia (BPD) remains a significant challenge in neonatology, with incidence rates stable despite advances, due to increased survival of extremely premature infants.
  • Key factors contributing to BPD pathogenesis include surfactant deficiency, lung injury from mechanical ventilation (volutrauma, barotrauma), and inflammation.
  • Current BPD prevention strategies aim to mitigate these postnatal insults and inflammatory processes.

Purpose of the Study:

  • To review recent advancements (last 5 years) in BPD prevention strategies.
  • To discuss novel surfactant preparations, corticosteroid use, and non-invasive ventilation techniques.
  • To explore emerging minimally invasive and non-invasive surfactant delivery methods.

Main Methods:

  • Literature review focusing on studies published within the last five years.
  • Analysis of research on surfactant therapy, corticosteroids, and ventilation strategies for BPD prevention.
  • Examination of novel delivery techniques for respiratory support.

Main Results:

  • Progress has been made in developing new surfactant preparations and optimizing their delivery.
  • Corticosteroid use and various non-invasive ventilation methods show promise in reducing BPD incidence.
  • Minimally invasive and non-invasive surfactant administration techniques are emerging as potential breakthroughs.

Conclusions:

  • Continued research into optimized surfactant therapy and lung-protective ventilation is crucial for BPD prevention.
  • Non-invasive respiratory support and novel delivery methods represent promising avenues for reducing BPD rates.
  • Mitigating ventilator-induced lung injury and inflammation remains the cornerstone of BPD prevention efforts.

Keywords:
Antenatal SteroidsBronchopulmonary DysplasiaChronic Lung DiseaseLungNIPPVNewborn, SurfactantNoninvasive VentilationPostnatal Corticosteroids

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