[From classic to new bronchopulmonary dysplasia]

Abstract

Chronic lung damage (bronchopulmonary dysplasia (BPD)) is one of the most serious complications affecting preterm neonates. During the last decade the aetiology of BPD has changed. Whereas 'classic BPD' was characterised mainly by lung damage and fibrosis caused by oxygen toxicity and mechanical ventilation, 'new BPD' is characterised by a disorder in lung development. This aetiological shift has been brought about by improved survival in extremely premature infants as a result of, for instance, antenatal corticosteroid administration and postnatal surfactant therapy. New BPD requires a new therapeutic approach. Therapeutic options for developing BPD include caffeine, vitamin A and postnatal corticosteroids. Once BPD has occurred, diuretics and inhaled bronchodilators and corticosteroids may be useful. However, the available therapies decrease the risk of developing BPD by just a small percent. In the future, artificial surfactants and non-invasive ventilation may prove to be useful in the prevention of BPD.