Prevention of Bronchopulmonary Dysplasia: A Summary of Evidence-Based Strategies

Jensen, Erik A.

doi:10.1542/neo.20-4-e189

Cited by 26 publications

(26 citation statements)

References 102 publications

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“…39 Antenatal steroids have not, however, been shown to reduce the risk for BPD in randomized controlled trials (RCTs) (RR 0.86, 95% CI 0.42-1.79) or larger observational studies. [39][40][41]…”

Section: Prevention Prenatal Steroidsmentioning

confidence: 99%

“…However, no studies have been published to date to definitively suggest that its use reduces the incidence of BPD. 40,55 Based on the evidence discussed the American Academy of Pediatrics (AAP) Committee on Fetus and Newborn made the recommendation to use CPAP immediately after birth with selective administration of surfactant. 56 They also stated that if the infant is likely to require a ventilator for respiratory support that "early administration of surfactant with rapid extubation is preferable to prolonged ventilation.…”

Section: Noninvasive Ventilationmentioning

confidence: 99%

“…A Cochrane meta-analysis of 32 clinical trials of early systemic steroid use found a correlation with a lower rate of extubation failures, decreased duration of intubation, and decreased risk of BPD. 40,78,79 The use of systemic steroids is unfortunately not without side effects. The Cochrane meta-analysis of early steroid use also reported increased rates of intestinal perforation, hyperglycemia, hypertension, hypertrophic cardiomyopathy, and growth failure.…”

Section: Steroidsmentioning

confidence: 99%

“…5,103 Supplementing vitamin A in premature infants is associated with a significant reduction in the composite outcome of death or oxygen requirement at one month of age and among survivors at 36 weeks' corrected age. 63,104,105 For these reasons, administration of intramuscular vitamin A is one of the few evidence-based pharmacologic agents recommended for the prevention of BPD, 40 but it is infrequently used, possibly because of the need for intramuscular injection. Recent difficulties in the supply have also been problematic.…”

Section: Antibioticsmentioning

confidence: 99%

“…Because of the pulmonary over-circulation associated with a patent ductus arteriosus (PDA), there is a correlation between the presence of a PDA and the later development of BPD. 40,61,62,106 Indomethacin and ibuprofen are the most commonly utilized medications to attempt to close the PDA non-surgically. The Trial of Indomethacin Prophylaxis in Preterms (TIPP) evaluated the benefits of early PDA treatment in very low birth weight infants.…”

Section: Patent Ductus Arteriosusmentioning

confidence: 99%

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<p>Bronchopulmonary Dysplasia: An Overview</p>

Gisondo¹,

Donn²

2020

RRN

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Bronchopulmonary dysplasia (BPD) is the most common long-term respiratory morbidity of infants born prematurely. Historically thought to be a direct consequence of lung injury from mechanical ventilation and exposure to high concentrations of oxygen, recent evidence suggests that the BPD of today may be the result of altered lung development and altered alveolarization. In this paper, we will review historical and contemporary definitions of BPD as well as frequently used prevention and management strategies.

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Section: Prevention Prenatal Steroidsmentioning

confidence: 99%

Section: Noninvasive Ventilationmentioning

confidence: 99%

Section: Steroidsmentioning

confidence: 99%

Section: Antibioticsmentioning

confidence: 99%

Section: Patent Ductus Arteriosusmentioning

confidence: 99%

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<p>Bronchopulmonary Dysplasia: An Overview</p>

Gisondo¹,

Donn²

2020

RRN

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Implementation of neurally adjusted ventilatory assist and high flow nasal cannula in very preterm infants in a tertiary level NICU

Piątek

Lehtonen

Parikka

et al. 2022

Pediatric Pulmonology

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Preterm infants treated with invasive ventilation are often affected by bronchopulmonary dysplasia, brain structure alterations, and later neurodevelopmental impairment. We studied the implementation of neurally adjusted ventilatory assist (NAVA) and high flow nasal cannula (HFNC) in a level III neonatal unit, and its effects on pulmonary and central nervous system outcomes. This retrospective cohort study included 193 surviving infants born below 32 weeks of gestation in preimplementa-

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Changes in ventilation modes in the last decade and their impact on the prevalence of bronchopulmonary dysplasia in preterm infants

Adler-Haltovsky

Gileles‐Hillel

Erlichman

et al. 2023

Pediatric Pulmonology

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Background Less invasive forms of ventilation have evolved aiming to decrease bronchopulmonary dysplasia (BPD) morbidity. It is unclear whether changes in ventilation practices have been associated with improvements in respiratory outcomes. Objective To examine the changes in ventilation modes in preterm neonates between two periods during the last decade and their impact on BPD prevalence. Methods A retrospective chart review of very low birth weight infants and those born at less than 32 weeks gestation hospitalized during two periods: the years 2012–2013 and 2018–2019. The primary outcome was the prevalence of BPD. Study variables included the mode and duration of ventilation, duration of oxygen need, and perinatal clinical parameters. Results Four hundred eighty‐one infants were enrolled. Between the two study periods, a significant increase was observed in invasive (33%–47%, p = 0.002), and noninvasive ventilation rates (44%–72%, p < 0.001). The average duration of noninvasive ventilation increased significantly (from 9.24 to 14.08 days, p = 0.016). The total duration of respiratory support remained unchanged. The overall prevalence of moderate and severe BPD at 36 weeks corrected age remained approximately 40% in preterm infants born at less than 28 weeks gestation. Conclusion The increasing use of non‐invasive ventilation was not accompanied by a reduction in the use of invasive ventilation, nor by a reduced prevalence of BPD. The high prevalence of BPD remains a significant problem in extreme prematurity. Other interventions, in addition to less aggressive ventilation, need to be explored.

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Prevention of Bronchopulmonary Dysplasia: A Summary of Evidence-Based Strategies

Cited by 26 publications

References 102 publications

<p>Bronchopulmonary Dysplasia: An Overview</p>

<p>Bronchopulmonary Dysplasia: An Overview</p>

Implementation of neurally adjusted ventilatory assist and high flow nasal cannula in very preterm infants in a tertiary level NICU

Changes in ventilation modes in the last decade and their impact on the prevalence of bronchopulmonary dysplasia in preterm infants

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