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Bronchopulmonary dysplasia-A historical perspective
Julian Allen1, Howard Panitch1
1Division of Pulmonary and Sleep Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Pediatric Pulmonology
|February 27, 2021
Summary
Bronchopulmonary dysplasia (BPD) has evolved from a condition caused by lung injury to one of interrupted lung development. Advances in neonatal care have improved survival and led to better treatments and long-term outcomes for affected infants.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Bronchopulmonary dysplasia (BPD) was first described in 1967, initially attributed to barotrauma and oxygen toxicity.
- Advances in neonatal intensive care have increased survival rates for preterm and very preterm infants.
- The understanding of BPD's pathogenesis has shifted towards an interruption of lung development.
Purpose of the Study:
- To describe the evolution of understanding BPD pathophysiology over 50 years.
- To review the development of BPD treatments.
- To highlight the impact of improved neonatal care on BPD outcomes.
Main Methods:
- Historical review of BPD research and clinical practice.
- Analysis of changing BPD pathology and pathogenesis.
- Examination of evolving treatment strategies and their impact.
Main Results:
- BPD understanding evolved from lung injury to disrupted lung development.
- Interventions are rooted in surface tension principles and molecular mechanisms.
- Newer treatments mitigate mechanical ventilation effects.
Conclusions:
- Improved neonatal care increases survival of vulnerable infants, altering BPD presentation.
- BPD is recognized as a chronic multi-system disease requiring ongoing care.
- Better BPD outcomes in childhood may improve adult respiratory health, potentially reducing chronic obstructive pulmonary disease.
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