Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-25T04:49:45.480Z Has data issue: false hasContentIssue false

Bronchopulmonary Dysplasia: Pharmacologic Treatments and Prediction of Outcome

Published online by Cambridge University Press:  10 March 2009

William E. Truog
Affiliation:
University of Washington School of Medicine

Extract

Bronchopulmonary dysplasia (BPD) is a progressive disorder of the lungs of newborn infants initially involving distal airways, but followed in weeks by the development of abnormalities in all parts of the lung architecture. BPD develops primarily but not exclusively in premature infants. The incidence in the general population has never been assessed accurately in a prospective manner. One retrospectively calculated incidence figure is 1.2 infants per 1,000 total live births per year in the United States (17). With approximately 4 million births annually in North America, there are about 5,000 babies each year who develop BPD. The additional weeks, months, and, in some cases, years of hospitalization, the frequent rehospitalizations, and the mortality of 20–50% beyond 1 month of age (17) underscore the disproportionate financial and emotional toll of BPD not only on patients and families but caregivers as well. The glacial rates of improvement in the illness, the frequent setbacks, and the profound disruption to family life all support the contention that BPD is a major public health problem.

Type
Neonatal Disorders of Respiration
Copyright
Copyright © Cambridge University Press 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Ariagno, R. L., Wilson, D. M., Ingillo, D., & Martin, D.The effect of dexamethasone on adrenal responsiveness in ventilator dependent preterm infants with bronchopulmonary. dysplasia (BPD). American Review of Respiratory Diseases, 1987, 135 (abst.), A125.Google Scholar
2.Avery, M. E., Tooley, W. H., Keller, J. B., HurdS., S. S., S., Bryan, H., Cotton, R. B., Epstein, M. F., Fitzhardinge, P. M., Hansen, C. B., Hansen, T. N., Hodson, W. A., James, L. S., Kitterman, J. A., Nielsen, H. C., Poirier, T. A., Truog, W. E., & Wung, J. T.Is chronic lung disease in low birth weight infants preventable? A survey of eight centers. Pediatrics, 1987, 79, 2630.CrossRefGoogle ScholarPubMed
3.Avery, G. B., Fletcher, A. B., Kaplan, M., & Brudno, D. S.Controlled trial of dexamethasone in respirator-dependent infants with brochopulmonary dysplasia. Pediatrics, 1985, 75, 106–11.CrossRefGoogle Scholar
4.Englehardt, B., Elliott, S., & Hazinski, T. A.Short- and long-term effects of furosemide on lung function in infants with bronchopulmonary dysplasia. Journal of Pediatrics, 1986, 109, 1034–39.CrossRefGoogle Scholar
5.Gibson, R. L., Jackson, J. C., Twiggs, G. A., Redding, G. J., & Truog, W. E.Bronchopulmonary dysplasia: survival after prolonged mechanical ventilation. American Journal of Diseases of Children, 1988, 142, 721–25.CrossRefGoogle ScholarPubMed
6.The HiFi Study Group and The Div. of Lung Diseases, National Heart, Lung and Blood Institute. A collaborate randomized trial of high frequency oscillatory ventilation in the treatment of respiratory failure in preterm infants. Pediatric Research, 1988, 22 (abst.).Google Scholar
7.Juul, S. E., Davis, C., Strandjord, T., Standaert, T. A., Stewart, B., Woodrum, D. E., Hodson, W. A., & Truog, W. E. Unpublished observations.Google Scholar
8.Kao, L. C. C., Warburton, D., Cheng, M. H., Cedeno, C., Platzker, A. C. G., & Keens, T. G.Effect of oral diuretics on pulmonary mechanics in infants with chronic bronchopulmonary dysplasia: Results of a double-blind crossover sequential trial. Pediatrics, 1984, 74, 3744.CrossRefGoogle ScholarPubMed
9.Kao, L. C., Warburton, D., Platzker, A. C. G., & Keens, T. G.Effect of isoproterenol inhalation on airway resistance in chronic bronchopulmonary dysplasia. Pediatrics, 1984, 73, 509514.CrossRefGoogle ScholarPubMed
10.Kao, L. C., Warburton, D., Sargent, C. C. W., Platzker, A. C. G., & Keens, T. G.Furosemide acutely decreases airways resistance in chronic brochopulmonary dysplasia. Journal of Pediatrics, 1983, 103, 624–29.CrossRefGoogle Scholar
11.Kehrer, J. P., Klein-Szanto, A. J. P., Sorensen, E. M. B., Pearlman, R., & Rosner, M. H.Enhanced acute lung damage following corticosteroid treatment. American Review of Respiratory Diseases, 1984, 130, 256–61.CrossRefGoogle ScholarPubMed
12.Mammel, M. C., Green, T. P., Johnson, D. E., & Thompson, T. R.Controlled trial of dexamethasone therapy in infants with bronchopulmonary dysplasia. Lancet, 1983, ii, 1356–57.CrossRefGoogle Scholar
13.McCann, E. M., Deming, D. D., Donovan, M. J., & Brady, J. P.Controlled trial of furosemide therapy in infants with chronic lung disease. Journal of Pediatrics, 1985, 106, 957–62.CrossRefGoogle ScholarPubMed
14.Motoyama, E. K., Fort, M. D., Klesh, K. W., Mutich, R. L., & Guthrie, R. D.Early onset of airway reactivity in premature infants with bronchopulmonary dysplasia. American Re view of Respiratory Diseases, 1987, 136, 5057.CrossRefGoogle ScholarPubMed
15.Rooklin, A. R., Moomjian, A. S., Shutack, J. G., Schwartz, J. G., & Fox, W. W.Theophylline therapy in bronchopulmonary dysplasia. Journal of Pediatrics, 1979, 95, 882–85.CrossRefGoogle ScholarPubMed
16.Shenai, J. P., Kennedy, K. A., Chytil, F., & Stahlman, M. T.Clinical trial of vitamin A supplementation in infants susceptible to bronchopulmonary dysplasia. Journal of Pediatrics, 1987, 111, 269277.CrossRefGoogle ScholarPubMed
17.Truog, W. E., Jackson, J. C., Badura, R. J., Sorensen, G. K., Murphy, J. H., & Woodrum, D. E.Bronchopulmonary dysplasia and pulmonary insufficiency of prematurity: Lack of correlation of outcome with gas exchange abnormalities at 1 month of age. American Journal of Diseases of Children, 1985, 139, 351–54.CrossRefGoogle ScholarPubMed
18.Weinstein, M. R., & Oh, W.Oxygen consumption in infants with bronchopulmonary dysplasia. Journal of Pediatrics, 1981, 99, 958962.CrossRefGoogle ScholarPubMed