Corticosteroids for the prevention and treatment of bronchopulmonary dysplasia: an overview of systematic reviews

Loo, Moniek van de; Kaam, Anton van; Offringa, Martin; Doyle, Lex W.; Onland, Wes

doi:10.1002/14651858.cd013271

Cited by 3 publications

(3 citation statements)

References 39 publications

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“…In prophylactic procedure, attempts are being made to use retinol, caffeine citrate, inhaled nitric oxide, beta-adrenomimetics, ipratropium bromide, diuretics and in newborns with confirmed colonization or infected with Ureaplasma urealyticum, also macrolide antibiotics, mainly azithromycin [50,51]. According to evidence-based data, GCSs are the unique recommended method of prevention of BPD in children and can significantly improve the short-term prognosis of patients [52][53][54][55][56].…”

Section: Current and Future Pharmacological Methods Of Prevention Andmentioning

confidence: 99%

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Pathophysiological mechanisms and pharmacological methods of prevention and treatment of bronchopulmonary dysplasia in preterm infants

Wątroba¹,

Bryda²

2019

J Pre Clin Clin Res.

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Wątroba S. J, Bryda J. Pathophysiological mechanisms and pharmacological methods of prevention and treatment of bronchopulmonary dysplasia in preterm infants. AbstractIntroduction. Bronchopulmonary dysplasia (BPD) is a respiratory disease that is characterized by long-term respiratory failure and mainly affects premature infants with low birth weight (LBW), undergoing mechanical ventilation (MV) or requiring long-term oxygen therapy. In Europe, among newborns with birth weight <1500g, the incidence of BPD is around 15%. Objective. The purpose of this review was to analyze the pathophysiological mechanisms involved in the development of BPD in premature newborns and to discuss the current possibilities of pharmacological prevention and treatment of BPD. Description of the state of knowledge. The BPD pathogenesis is multifactorial. Lung damage is the result of barotrauma and volutrauma due to high-performance MV, actions of reactive oxygen species (ROS) and infectious agents. Currently used methods of pharmacological treatment of severe forms of BPD are mainly based on systemic steroid therapy and can not be considered completely effective and free of side effects. Conclusion. Despite the widespread use of proper pharmacotherapy and dynamic development of new methods of respiratory therapy, mortality in BPD is estimated at around 10% -20%. Infants with BPD are much more exposed to respiratory infections caused by respiratory syncytial virus (RSV), which may result in the development of bronchial hyperresponsiveness and bronchial asthma. Among children with BPD there are significantly higher cognitive and behavioral deficits compared to healthy children, and cerebral palsy is also significantly more common.Abbreviations AA -arachidonic acid; AAP COFN -Committee on Foetus and Newborn of the American Academy of Pediatrics; ACTHadrenocorticotropin; ADH -vasopressin, antidiuretic hormone; ASMC -airway smooth muscle cells; BPD -bronchopulmonary dysplasia; BTN -betamethasone; CAT -catalase; CC10 -Clara cell 10 kDa protein; CLD -chronic lung disease; COXcyclooxygenase; CPAP -continuous positive airway pressure; CPS FNC -Fetus and Newborn Committee of the Canadian Pediatric Society; DEX -dexamethasone; ELBW -extremely low birth weight; ENA-78 -epithelial protein activating neutrophils; EURAIL -Europe Against Immature Lung; FC -fludrocortisone; FiO 2 -oxygen concentration in the breathing mixture; FTP -fluticasone propionate; GCSs -glucocorticosteroids; GM-CSF -granulocyte and macrophage colonystimulating factor; GPx -glutathione peroxidase; HC -hydrocortisone; HO . -hydroxyl radical; HO 2 . -hydroperoxide radical; IFN-γ -gamma interferon; ILs -interleukins; IRDS -respiratory distress syndrome; IUGR -intrauterine growth retardation; IVH -intraventricular haemorrhage; LBW -low birth weight; LTs -leukotrienes; MAS -meconium aspiration syndrome; MIP-1 -macrophage inflammatory protein-1; MMPs -metalloproteinases; MRI -magnetic resonance imaging; MV -mechanical ventilation; n-CPAP -continuous positive airway pressure -nasal metho...

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Section: Current and Future Pharmacological Methods Of Prevention Andmentioning

confidence: 99%

“…Postnatal steroid therapy of BPD. Postnatal GCSs supply is currently the most commonly used BPD prophylaxis method [52,53]. GCSs show a symptomatic effect on the development of inflammation without affecting its cause [57].…”

Section: Current and Future Pharmacological Methods Of Prevention Andmentioning

confidence: 99%

Pathophysiological mechanisms and pharmacological methods of prevention and treatment of bronchopulmonary dysplasia in preterm infants

Wątroba¹,

Bryda²

2019

J Pre Clin Clin Res.

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“…Bronchopulmonary dysplasia (BPD) is a common complication of preterm birth. Recent evidence suggests that the use of physiological doses of hydrocortisone for the prevention of death or BPD may outweigh the potential risks 1–3. Starting in 2019, all infants born <28 weeks gestational age (GA) in our tertiary care NICU received physiologic doses of hydrocortisone, starting within 24 hours post-birth.…”

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confidence: 99%