0518. BPD in the 21st century

Developments over the past few decades have resulted in improved survival of VLBW and ELBW infants while outcomes research has demanded that we become increasingly vigilant in terms of consequences of our interventions. Bronchopulmonary dysplasia (BPD) remains a focus of attention, with conflicting results reported for BPD rates in the face of improved survival. Some studies report higher rates in spite of access to exogenous surfactant and less use of mechanical ventilation, while others report vastly improved rates for time-based cohorts, not only in terms of frequency of BPD but also in terms of severity. However, what is consistent is that the entity of BPD still exists, and neonatologists continue to explore the best management options for prevention. Dexamethasone has been used since the 1980s to both prevent and treat BPD, and it was inevitable that the timing, duration and dose of therapy would be researched. At this point one should accept that early treatment (<48 hours of life) is associated with unacceptable sequelae that probably don't justify the short-term improvements in lung function. These sequelae include hypertension, hyperglycemia, gastro-intestinal complications and neurodevelopmental delay.

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Eur J Pediatr 2005. April 28 Epub (Pubmed)
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