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Ventilation Strategies in Severe Bronchopulmonary Dysplasia

Kathleen Gibbs1, Erik A Jensen1, Stamatia Alexiou2

  • 1Divisions of Neonatology and.

Neoreviews
|April 3, 2020
PubMed

Insights

Bronchopulmonary dysplasia (BPD) management requires a shift from acute to chronic care strategies. This approach supports lung growth and repair in premature infants needing prolonged ventilation.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Developmental Biology

Background:

  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease in premature infants.
  • Severe BPD often necessitates prolonged positive pressure ventilation.
  • BPD presents unique lung mechanics distinct from respiratory distress syndrome.

Purpose of the Study:

  • To highlight the need for distinct respiratory support strategies in severe BPD.
  • To advocate for a chronic care model in managing infants with severe BPD.
  • To emphasize optimizing lung growth and repair in BPD.

Main Methods:

  • Review of current ventilation strategies for premature infants.
  • Analysis of lung mechanics in BPD versus respiratory distress syndrome.
  • Comparison of acute versus chronic care ventilation models.

Main Results:

  • Acute care ventilation strategies may not be optimal for severe BPD.
  • Chronic care models with less frequent adjustments are beneficial.
  • Tailored positive pressure support aids lung growth and repair.

Conclusions:

  • Management of severe BPD should transition from acute to chronic care principles.
  • Ventilator strategies must account for BPD's heterogeneous nature and promote lung development.
  • A shift in care models can improve long-term outcomes for infants with BPD.

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