pediatrics
Bronchopulmonary Dysplasia (BPD)
Prevention of Bronchopulmonary Dysplasia
Practices for prevention of BPD include Use of antenatal corticosteroids as indicated Prophylactic use of exogenous surfactant in selected high-risk infants (eg, weighing<1000 g and requiring ventilator support) Early therapeutic continuous positive airway pressure Early use of surfactant for treatment of respiratory distress syndrome (RDS) Prophylactic use of methylxanthines (eg,caffeine5 to 10 mg/kg orally once/day), particularly when birth weight is < 1250 g Permissive hypercarbia and hypoxemia to achieve low ventilator pressures, volumes, or both 1000 g (not widely used because of high cost, limited availability, and need for frequent IM injections; Prevention reference ) Avoidance of large volumes of fluid Inhaled nitric oxide has been studied and may help prevent BPD. However, optimal dosage, duration, and timing are unclear, so nitric oxide is not yet recommended outside of research protocols. 1.Aschner JL, Bancalari EH, McEvoy CT: Can we prevent bronchopulmonary dysplasia?J Pediatr189:26–30, 2017. doi: 10.1016/j.jpeds.2017.08.005 