Published online May 26, 2009
PEDIATRICS Vol. 123 No. 6 June 2009, pp. 1562-1573 (doi:10.1542/peds.2008-1962)
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STATE-OF-THE-ART REVIEW ARTICLE

Pitfalls, Problems, and Progress in Bronchopulmonary Dysplasia

Anita Bhandari, MDa and Vineet Bhandari, MD, DMb

a Division of Pediatric Pulmonology, Connecticut Children's Medical Center, Hartford, Connecticut
b Division of Perinatal Medicine, Yale University School of Medicine, New Haven, Connecticut

ABSTRACT

Bronchopulmonary dysplasia is a chronic lung disease associated with premature birth and characterized by early lung injury. In this review we discuss some pitfalls, problems, and progress in this condition over the last decade, focusing mainly on the last 5 years, limited to studies in human neonates. Changes in the definition, pathogenesis, genetic susceptibility, and recent biomarkers associated with bronchopulmonary dysplasia will be discussed. Progress in current management strategies, along with novel approaches/therapies, will be critically appraised. Finally, recent data on long-term pulmonary and neurodevelopmental outcomes of infants with bronchopulmonary dysplasia will be summarized.

Key Words: chronic lung disease • prematurity • pulmonary sequelae • noninvasive ventilation

Abbreviations: BPD—bronchopulmonary dysplasia • GA—gestational age • BW—birth weight • PMA—postmenstrual age • TA—tracheal aspirate • IL—interleukin • VEGF—vascular endothelial growth factor • RCT—randomized controlled trial • CPAP—continuous positive airway pressure • FIO2—fraction of inspired oxygen • iNO—inhaled nitric oxide • SOD—superoxide dismutase • CT—computed tomography

Accepted Sep 24, 2008.


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