1.- Postnatal corticosteroids to prevent or treat bronchopulmonary dysplasia - Who might benefit?
Doyle LW Semin Fetal Neonatal Med. 2017 Oct;22(5):290-295.
2.- Bronchopulmonary dysplasia
3.- Controversies about the definition of bronchopulmonary dysplasia at 50 years
Alan H. Jobe , Eduardo H. Bancalari Acta Pædiatrica.2017.106, pp. 692–693
4.- ¿ Can We Define Bronchopulmonary Dysplasia ?
Alan H. Jobe
Journals of Pediatrics September 2017Volume 188, Pages 19–23
5.- Hydrocortisone Treatment for Bronchopulmonary Dysplasiaand Brain Volumes in Preterm Infants
Karina J. Kersbergen J Pediatr 2013;163:666-71
Objective To assess whether there was an adverse effect on brain growth after hydrocortisone (HC) treatment for bronchopulmonary dysplasia (BPD) in a large cohort of infants without dexamethasone exposure.
Study design Infants who received HC for BPD between 2005 and 2011 and underwent magnetic resonance imaging at term-equivalent age were included. Control infants born in Geneva (2005-2006) and Utrecht (2007-2011) were matched to the infants treated with HC according to segmentation method, sex, and gestational age. Infants with overt parenchymal pathology were excluded. Multivariable analysis was used to determine if there was a difference in brain volumes between the 2 groups.
Results Seventy-three infants treated with HC and 73 matched controls were included. Mean gestational age was 26.7 weeks, and mean birth weight was 906 g. After correction for gestational age, postmenstrual age at time of scanning, the presence of intraventricular hemorrhage, and birth weight z-score, no differences were found between infants treated with HC and controls in total brain tissue or cerebellar volumes.
Conclusions In the absence of associated parenchymal brain injury, no reduction in brain tissue or cerebellar volumes could be found at term-equivalent age between infants with or without treatment with HC for BPD.
6.- Revisiting the Definition of Bronchopulmonary Dysplasia Effect of Changing Panoply of Respiratory Support for Preterm Neonates
Tetsuya Isayama y cols for the Canadian Neonatal Network and Canadian Neonatal Follow-Up Network Investigators
JAMA Pediatr. 2017;171(3):271-279. doi:10.1001/jamapediatrics.2016.4141
IMPORTANCE Several definitions of bronchopulmonary dysplasia are clinically used; however, their validity remains uncertain considering ongoing changes in the panoply of respiratory support treatment strategies used within neonatal units.
OBJECTIVE To identify the optimal definition of bronchopulmonary dysplasia that best predicts respiratory and neurodevelopmental outcomes in preterm infants.
DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study at tertiary neonatal intensive care units. Preterm infants born at less than 29 weeks’ gestation between 2010 and 2011 who were admitted to neonatal intensive care units participating in the Canadian Neonatal Network and completed follow-up assessments in a Canadian Neonatal Follow-Up Network clinic at 18 to 21 months.
EXPOSURES Various traditional bronchopulmonary dysplasia criteria based on respiratory status at different postmenstrual ages.
MAIN OUTCOMES AND MEASURES Serious respiratory morbidity, neurosensory impairment at 18 to 21 months of age, and a composite outcome of respiratory or neurosensory morbidity or death after discharge. Adjusted odds ratios (AORs) and 95%CIs were calculated.
RESULTS Of 1914 eligible survivors, 1503 were assessed (mean gestational age was 26.3 weeks; 68%were white, 9%were black, and 23%were other race/ethnicity), 88 had serious respiratory morbidity, 257 infants had neurosensory impairment, and 12 infants died after discharge. Definitions using oxygen requirement alone as the criterion at various postmenstrual ages were less predictive compared with those using the criterion of oxygen/respiratory support (RS) (receiving supplemental oxygen and/or positive-pressure RS); among those, oxygen/RS at 36 weeks had the highest AOR and area under the curve (AUC) for all outcomes. Further analyses of oxygen/RS at each week between 34 and 44 weeks’ postmenstrual age indicated that the predictive ability for serious respiratory morbidity increased from 34 weeks (AOR, 1.8; 95%CI, 0.9-3.4, AUC, 0.721) to 40 weeks (AOR, 6.1; 95%CI, 3.4-11.0; AUC, 0.799). For serious neurosensory impairment, the AOR and AUC at 40 weeks’ PMA (AOR, 1.5, 95%CI, 1.0-2.1; AUC, 0.740) were only marginally below their peak values at 37 weeks’ PMA (AOR, 1.8; 95%CI, 1.3-2.6; AUC, 0.743).
CONCLUSIONS AND RELEVANCE Defining bronchopulmonary dysplasia by the use of oxygen alone is inadequate because oxygen/RS is a better indicator of chronic respiratory insufficiency. In particular, oxygen/RS at 40 weeks’ PMA was identified as the best predictor for serious respiratory morbidity, while it also displayed a good ability to predict neurosensory morbidity at 18 to 21 months. JAMA
7.- Bronchopulmonary dysplasia: A review of pathogenesis and pathophysiology.
Kalikkot Thekkeveedu R Respir Med. 2017 Nov;132:170-177.