Precision Medicine in Neonates: Future Perspectives for the Lung

Area of Science:

• Neonatal respiratory medicine
• Precision medicine in pediatrics

Background:

• Bronchopulmonary dysplasia (BPD) is a common, long-term complication of preterm birth.
• Current BPD prevention strategies are population-based, overlooking patient diversity.
• Individualized care for preterm lungs is limited despite clinical need.

Purpose of the Study:

• To review emerging pulmonary research for individualizing lung protective interventions in preterm infants.
• To explore novel diagnostic and monitoring tools for BPD prevention.
• To highlight the potential of precision medicine in neonatal respiratory care.

Main Methods:

• Narrative review of potential advancements in BPD research.
• Discussion of bedside monitoring tools: electrical impedance tomography and diaphragmatic electromyography.
• Exploration of genetic variation in caffeine metabolism and volatile organic compound analysis.

Main Results:

• Electrical impedance tomography and diaphragmatic electromyography offer non-invasive, regional lung assessment for optimizing respiratory support.
• Genomic analysis of caffeine metabolism can personalize caffeine dosing regimens.
• Exhaled breath volatile organic compounds may predict BPD early, enabling timely preventive actions.

Conclusions:

• Electrical impedance tomography, diaphragmatic electromyography, personalized caffeine dosing, and breath analysis show promise for individualized BPD prevention.
• Further research is needed to address technical challenges, validate these tools, and demonstrate their clinical impact on BPD prevention.