Management of infants with bronchopulmonary dysplasia in North America

Early Hum Dev. 2005 Feb;81(2):171-9. doi: 10.1016/j.earlhumdev.2004.12.005. Epub 2005 Jan 16.

Abstract

The in-hospital management of infants with BPD includes minimizing the duration of mechanical ventilation and avoiding the use of high inspired oxygen concentrations while maintaining adequate oxygenation. Fluid restriction, bronchodilators, and diuretic therapy can improve lung function and reduce the need for supplemental oxygen and high ventilator settings, but do not change the ultimate course of these infants. Corticosteroids also improve lung function and accelerate weaning from oxygen and mechanical ventilation, but their use during the first weeks of life is associated with worse neurological outcome. Adequate nutrition plays an important role in lung injury protection and recovery. Infants with severe BPD frequently develop pulmonary hypertension and may benefit from the use of pulmonary vasodilators. Outpatient management must be carefully planned and carried out by experienced multidisciplinary teams. Social and financial issues must be addressed with the family and caregivers. Home oxygen and mechanical ventilation therapy are used frequently after discharge and require specialized staff and equipment. Maintenance of oxygenation and proper nutritional support are critical aspects in the post-discharge management of these infants. Immunizations and RSV prevention are also important to prevent infections in these vulnerable immunocompromised patients.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Ambulatory Care / methods
  • Bronchodilator Agents / therapeutic use
  • Bronchopulmonary Dysplasia / therapy*
  • Diuretics / therapeutic use
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • North America
  • Nutritional Physiological Phenomena
  • Oxygen Inhalation Therapy / methods*
  • Respiration, Artificial / methods
  • Vasodilator Agents / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Bronchodilator Agents
  • Diuretics
  • Vasodilator Agents