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Bronchopulmonary Dysplasia Within and Beyond the Neonatal Unit

Khetan, Renu MBBS, DCH, MRCPCH; Hurley, Matthew BSc (Hons), MBBCh, MRCPCH; Spencer, Sarah RN (Child), BSc (Hons); Bhatt, Jayesh M. MBBS, DCH (London), MD, FRCPCH

Section Editor(s): Newnam, Katherine

doi: 10.1097/ANC.0000000000000251
Special Series: Respiratory Management
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Background: Bronchopulmonary dysplasia (BPD), also known as chronic lung disease of prematurity or chronic neonatal lung disease, is a major cause of respiratory illness in premature babies. Newborn babies survive at gestational ages of 23 to 26 weeks, earlier than when BPD was first described. New mechanisms of lung injury have therefore emerged and the clinical and pathological characteristics of pulmonary involvement have changed.

Purpose: Improved neonatal intensive care unit modalities have increased survival rates; the overall prevalence of the condition, however, has not changed. Management of evolving BPD aims at minimizing lung injury. Management of established, especially severe BPD, still poses significant clinical challenge as these babies need long-term oxygen therapy (LTOT) for variable length of time. We aim to give an overview of management of established BPD with particular focus on weaning home oxygen therapy at our local center in the United Kingdom.

Search and Results: On the basis of most recent evidence, we concluded that an integrated pathway for managing babies on LTOT is very important after discharge from neonatal unit.

Implications for Practice: A structured weaning pathway for premature babies on home oxygen improves outcome.

Implications for Research: The management of severe BPD and related complications, particularly during the first 2 years of life, remains a continuing challenge for parents and healthcare providers. The most beneficial respiratory support strategy to minimize lung injury and/or promote lung healing remains unclear and requires further investigation.

Department of Paediatric Respiratory Medicine (Drs Khetan, Hurley, and Bhatt) and Children's Community Nursing (Ms Spencer), Nottingham Children's Hospital, Queens Medical Centre, Nottingham, United Kingdom.

Correspondence: Jayesh M. Bhatt, MBBS, DCH (London), MD, FRCPCH, Department of Paediatric Respiratory Medicine, Nottingham Children's Hospital, Queens Medical Centre, Derby Rd, Nottingham, NG7 2UH, United Kingdom (Jayesh.bhatt@nuh.nhs.uk).

There is no conflict of interest.

© 2016 by The National Association of Neonatal Nurses