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Long-term outcomes of infants with severe BPD

Joseph M Collaco1, Sharon A McGrath-Morrow2

  • 1Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University, Baltimore, MD, United States.

Seminars in Perinatology
|March 31, 2024
PubMed

Insights

Bronchopulmonary dysplasia (BPD) affects preterm infants due to disrupted lung development and respiratory support. This review examines BPD phenotypes and long-term health outcomes in children.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Developmental Biology

Background:

  • Preterm birth significantly alters normal lung development, increasing the risk of bronchopulmonary dysplasia (BPD).
  • Interventions like positive pressure ventilation and supplemental oxygen, while necessary, can worsen lung injury in preterm infants.
  • Bronchopulmonary dysplasia affects approximately 50,000 US infants annually, presenting with diverse and age-dependent respiratory pathologies.

Approach:

  • This review examines common respiratory endotypes in infants and children with severe BPD.
  • It analyzes the heterogeneity of BPD phenotypes, including alveolar, airway, and vascular components.
  • The influence of gestational age and respiratory support on BPD endotype development is discussed.

Key Points:

  • BPD phenotypes are varied and can evolve throughout childhood, impacting different respiratory tract regions.
  • Small airway disease is a prevalent phenotype in school-aged children and adolescents with BPD.
  • Gestational age and the type/duration of respiratory support are critical factors influencing BPD development.

Conclusions:

  • Understanding diverse BPD endotypes is crucial for predicting long-term pulmonary outcomes.
  • This review highlights the variability in long-term prognoses for cardiovascular, neurological, and gastrointestinal systems in children with severe BPD.
  • Persistent small airway disease is a significant factor in the chronic respiratory health of individuals with a history of severe BPD.

Keywords:
Bronchopulmonary dysplasiaLifespanPulmonary outcomes

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