Introduction
Pathogenesis
Clinical
Prevention
Management
Prognosis
References
Abbreviations
Other Lectures
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Antenatally, the goal is to avoid or at least delay premature birth. Strategies include aggressive treatment of infection and premature labor and use of antenatal steroids.
Postnatal treatment goals center around minimizing exposure to oxygen and mechanical ventilation. Early surfactant treatment of babies with HMD has shown a slight decrease in the incidence of BPD, although it has unquestionably also been associated with a remarkable decrease in BPD severity. Surfactant rescue therapy (late treatment) decreases mortality with little effect on BPD incidence. "Gentle" ventilation strategies, emphasizing permissive hypercapnia (pCO2 45-55 mm Hg) are designed to minimize barotrauma. High-frequency oscillatory ventilation (HFOV) may reduce lung inflammation but the evidence does not show a BPD reducing effect.
Vitamin A supplementation of VLBWs has shown a small reduction in BPD incidence. Limiting fluid intakes to prevent PDA, although intuitively reasonable, has not been studied prospectively.
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