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Respiratory management of established severe bronchopulmonary dysplasia

George T El- Ferzli1, Maria Jebbia1, Audrey N Miller1

  • 1Division of Neonatology, Department of Pediatrics, Ohio State University, Nationwide Children's Hospital, Columbus, OH, United States; Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital, Columbus, OH, United States.

Seminars in Perinatology
|September 27, 2023
PubMed

Insights

Managing infants with severe bronchopulmonary dysplasia (BPD) requires careful respiratory support. The focus is on ensuring full exhalation to maintain oxygenation and ventilation, prioritizing long-term growth and neurodevelopment.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Respiratory Physiology

Background:

  • Severe bronchopulmonary dysplasia (BPD) presents significant challenges in infant respiratory management.
  • Established BPD physiology is characterized by an obstructive pattern, leading to prolonged exhalatory time constants.

Purpose of the Study:

  • To outline strategies for respiratory management in infants with severe BPD.
  • To emphasize the importance of achieving full exhalation for adequate oxygenation and ventilation.

Main Methods:

  • The study reviews the well-described physiology of severe BPD.
  • It discusses ventilator management principles focused on optimizing exhalation.
  • It highlights the need for a chronic care approach.

Main Results:

  • Effective respiratory management in severe BPD necessitates maintaining adequate oxygenation and ventilation.
  • Achieving full exhalation is a critical component of ventilator management.
  • A culture of chronic care is imperative for steady progress.

Conclusions:

  • Respiratory management for severe BPD requires a focus on facilitating exhalation.
  • Transitioning to a chronic care model is crucial once respiratory stability is achieved.
  • Post-stability care should prioritize infant growth, development, and avoidance of neurodevelopmental impairments.

Keywords:
None

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