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Updated: Sep 10, 2025

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
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Bronchopulmonary Dysplasia in the First Year: Insights Into Severity, Medication Use, and Healthcare Utilization

Eliaz Brumer1,2, Veronika Shabanova2,3, Haley Urbach2

  • 1Department of Pediatrics, Section of Pulmonary, Allergy-Immunology, and Sleep Medicine, Yale University, New Haven, Connecticut, USA.

Pediatric Pulmonology
|August 26, 2025
PubMed

Insights

Infants with bronchopulmonary dysplasia (BPD) face significant respiratory issues and healthcare needs post-discharge, increasing with disease severity. Structured follow-up is crucial for all BPD patients, regardless of severity, to manage respiratory morbidity.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Respiratory Medicine

Background:

  • Bronchopulmonary dysplasia (BPD) is a prevalent chronic lung disease in premature infants.
  • Understanding BPD severity's impact on respiratory outcomes and healthcare use is critical for optimizing care.
  • The role of NICU interventions like dexamethasone and post-NICU follow-up requires further characterization.

Purpose of the Study:

  • To examine the association between BPD severity and post-NICU respiratory outcomes and healthcare utilization.
  • To evaluate the impact of outpatient pediatric pulmonology follow-up on respiratory morbidity.
  • To assess the influence of dexamethasone administration during NICU stay on postdischarge respiratory health.

Main Methods:

  • Retrospective cohort study of 161 infants diagnosed with BPD (2021-2023) using the 2019 severity classification.
  • Key outcomes assessed: medication prescriptions (albuterol, inhaled/systemic steroids), ED visits, and hospital admissions within one year post-NICU discharge.
  • Analysis of dexamethasone use, pulmonology follow-up, and respiratory morbidity associations.

Main Results:

  • BPD severity distribution: 32.9% grade-1, 59.0% grade-2, 8.1% grade-3.
  • Dexamethasone use and pulmonology follow-up rates increased with BPD severity (p<0.001).
  • Nearly half (47.2%) experienced postdischarge respiratory hospital visits; 22.3% were hospitalized.

Conclusions:

  • Respiratory morbidity and healthcare utilization in infants with BPD increase with disease severity.
  • A significant burden of respiratory hospital visits exists across all BPD severity levels, including milder cases.
  • Structured longitudinal follow-up is essential for all infants with BPD to mitigate respiratory morbidity.
Abstract

Keywords:
bronchopulmonary dysplasiapediatric pulmonologyprematurity

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