Bronchopulmonary dysplasia (BPD) is the term used for lung disease of prematurity. Advances in neonatal care, like prenatal steroid therapy and surfactant therapy, have led to substantial changes in the clinical and pathological characteristics of BPD. The definitions of BPD have also changed; the current definitions include (1) total duration of oxygen supplementation requirement for >28 days, (2) degree of prematurity (<32 weeks gestational age at birth), and (3) oxygen dependency at 36 weeks Postmenstrual Age (PMA) to characterize three degrees of severity. Infants who meet the 1st two criteria for BPD, but do not require oxygen at 36 weeks PMA are defined with âmildâ BPD. Infants who require <30% oxygen at 36 weeks PMA are defined with âmoderateâ BPD, and infants who require >30% and/ or positive pressure at 36 weeks PMA are defined with âsevereâ BPD. Neither older nor newer definitions are very effective at describing pulmonary outcomes in the most severely affected infants; even the most recent definitions underestimate lung disease, as many premature infants born at early gestational ages are discharged home well after 36 weeks PMA.
Management of Severe Chronic Lung Disease of Prematurity: Lawrence M Rhein
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Last date updated on June, 2014