Bronchopulmonary dysplasia with focus on early prediction and treatment: a narrative review

Abstract

Background and Objective: Bronchopulmonary dysplasia (BPD) remains a major cause of morbidity and mortality in very preterm infants though early non-invasive ventilation and surfactant treatment and other neonatal therapies have improved the outcome. Therefore, it is necessary to find effective supplemental methods for prediction of BPD. Better understanding of the etiology and molecular mechanisms involved in the pathogenesis of BPD is necessary for development of new effective early treatments. It is generally accepted that BPD is a multifactorial disease often associated with intrauterine infections and placental perfusion disorders. Methods: Recently a new method to predict BPD at birth using artificial intelligence (AI) has been developed. This new method improves the likelihood of developing effective early treatments for BPD. The method combines information on early surfactant treatment, birth weight and gestational age (GA) with analysis of the mid-infrared spectrum of the molecules in gastric aspirate which are produced in the newborn’s lungs. The described methods for early treatment of BPD in this review among others covers inositol, retinol, super oxide dismutase, Clara cell 10 protein, corticosteroids, azithromycin, macrolide and stem cell therapy besides general treatments as nasal continuous positive airway pressure (NCPAP), surfactant, caffeine, oxygen saturation targeting and nutrition. The literature search was performed systemically online via the databases PubMed and Medline between January 1, 2011 and December 31, 2022. Key Content and Findings: A method to predict BPD immediately after birth is now available allowing possibility to develop effective early treatments of BPD. Conclusions: The present review focuses on early prediction and the existing pharmacologic interventions highlighting the potential to improve the outcome of infants with BPD

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