Advances in care now make it possible for more premature infants to survive. Ironically, many of the very interventions employed to ensure their viability such as mechanical ventilation and long-term use of oxygen can put many of these infants at high risk for bronchopulmonary dysplasia.
Despite improvements in obstetric and neonatal care leading to increased survival of premature infants, little progress has been made in the prevention of bronchopulmonary dysplasia. Pediatricians need to be aware of changing definitions, risk factors, prevention, and long-term health outcomes of this disease in their premature patients.
Hospital discharge for extremely low-birth-weight (ELBW) infants, defined as those born at 28 weeks or earlier and weighing less than 1000 g at birth, often means significant ongoing health challenges for these babies and their families.
Boston Children’s bronchopulmonary dysplasia (BPD) rehospitalization rates for children aged 1 and 2 years are dramatically lower than the national average. Lawrence Rhein, MD, a neonatologist and pulmonologist, and director of the Center for Healthy Infant Lung Development, Boston Children’s Hospital, Massachusetts, says it’s not high-priced technology that keeps children with this serious lung disease out of the hospital.
There’s good news for premature infants with bronchopulmonary dysplasia (BPD): treatment with hydrocortisone does not seem to adversely effect brain growth, meaning that hydrocortisone may provide a safer alternative to dexamethasone.