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Pharmacotherapy in Bronchopulmonary Dysplasia: What Is the Evidence?
Rishika P Sakaria1, Ramasubbareddy Dhanireddy1,2
1Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.
Insights
Bronchopulmonary Dysplasia (BPD) is a serious condition in preterm infants. This review examines common medications like corticosteroids, caffeine, and diuretics, offering evidence-based guidance for their use in preventing and managing BPD.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Pharmacology
Background:
- Bronchopulmonary Dysplasia (BPD) affects over 35% of extremely preterm infants.
- BPD is a leading cause of morbidity and mortality in premature neonates, with incidence rising as gestational age decreases.
- Inflammation is a key factor in BPD pathogenesis, leading to various therapeutic interventions.
Purpose of the Study:
- To review the current literature on commonly used medications for BPD prevention and management.
- To provide evidence-based recommendations for neonatologists and neonatal care providers.
- To address the lack of consensus regarding the use and benefits of these medications.
Main Methods:
- Comprehensive literature search on corticosteroids, caffeine, and diuretics in extremely preterm infants.
- Analysis of studies focusing on BPD prevention and treatment outcomes.
- Synthesis of available evidence to formulate recommendations.
Main Results:
- Corticosteroids, caffeine, and diuretics are frequently administered to extremely preterm infants.
- Evidence regarding the consensus on the benefits and optimal use of these medications remains limited.
- The review consolidates findings on efficacy and safety profiles.
Conclusions:
- Further research is needed to establish clear guidelines for medication use in BPD.
- Neonatal providers require updated, evidence-based recommendations for managing BPD.
- Optimizing medication strategies can improve outcomes for extremely preterm infants affected by BPD.
Abstract:
Bronchopulmonary Dysplasia (BPD) is a multifactorial disease affecting over 35% of extremely preterm infants born each year. Despite the advances made in understanding the pathogenesis of this disease over the last five decades, BPD remains one of the major causes of morbidity and mortality in this population, and the incidence of the disease increases with decreasing gestational age. As inflammation is one of the key drivers in the pathogenesis, it has been targeted by majority of pharmacological and non-pharmacological methods to prevent BPD. Most extremely premature infants receive a myriad of medications during their stay in the neonatal intensive care unit in an effort to prevent or manage BPD, with corticosteroids, caffeine, and diuretics being the most commonly used medications. However, there is no consensus regarding their use and benefits in this population. This review summarizes the available literature regarding these medications and aims to provide neonatologists and neonatal providers with evidence-based recommendations.
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