Recent Advances in the Management of Bronchopulmonary Dysplasia

Abstract Purpose of review Bronchopulmonary dysplasia (BPD) remains a very common complication of extreme prematurity and has significant adverse long-term consequences. Specific treatments to prevent the development of BPD or to treat established BPD are very limited. We have reviewed recent advances in the management of preterm-born infants at risk of developing BPD and in those with established BPD as well as potential future emerging treatment options. Recent findings Strategies to prevent iatrogenic lung trauma, such as non-invasive respiratory support and administration of exogeneous surfactant in a less invasive manner have now become embedded in clinical practice, but further studies are ongoing with the POLAR and SURFSUP trials aiming to refine these interventions. Strategies, other than postnatal systemic corticosteroids, to suppress lung inflammation have also been evaluated. However, both the early use of azithromycin and administration of endotracheal budesonide mixed with exogenous surfactant have not shown benefits for survival without development of BPD. Later in life, survivors of BPD at school-age show significant improvement in lung function with combined inhaled corticosteroids and long-acting beta 2 adrenoreceptor agonists, but therapeutic options to improve long term lung function are urgently required. Summary Further detailed understanding of the underlying mechanisms for the development of BPD are required so targeted treatments can be developed.