Division of Asthma, Allergy and Lung Biology, School of Medicine, King's College London, London, UK.
J Perinat Med. 2013 Jan;41(1):119-26. doi: 10.1515/jpm-2012-0084.
Bronchopulmonary dysplasia (BPD), defined as oxygen dependency for at least 28 days after birth, is a common adverse outcome of very premature birth. Affected children require frequent readmissions to hospital in the fi rst 2 years, and although lung growth and remodelling results in progressive improvement in lung function, airflow abnormalities may remain. Indeed, the most severely affected experience troublesome respiratory symptoms as adolescents and young adults. As a consequence, many potential preventative strategies have been investigated, and some have resulted in a reduction in BPD but with a negative risk/benefit ratio, for example, postnatal corticosteroids. Others therapies, namely antenatal corticosteroids and postnatal surfactant, have resulted in significant benefits to infants, including reductions in respiratory distress syndrome, necrotising enterocolitis, intraventricular haemorrhage and neonatal death, but have not impacted favourably on the incidence of BPD, perhaps due to the increased survival of very immature infants. In one major trial, it has been shown that BPD can be reduced without adverse effects by caffeine administration. Avoidance of high oxygen concentrations at resuscitation is also a promising approach to reduce BPD.
支气管肺发育不良（BPD）定义为出生后至少需要氧疗 28 天，是极早产儿常见的不良结局。受影响的儿童在出生后 2 年内需要频繁住院，尽管肺生长和重塑导致肺功能逐渐改善，但气流异常仍可能存在。事实上，最严重的患者在青少年和年轻成人时期会出现麻烦的呼吸道症状。因此，已经研究了许多潜在的预防策略，但有些策略虽然降低了 BPD 的发生率，但风险/效益比为负，例如，产后皮质类固醇。其他治疗方法，即产前皮质类固醇和产后表面活性剂，使婴儿显著受益，包括降低呼吸窘迫综合征、坏死性小肠结肠炎、脑室出血和新生儿死亡，但对 BPD 的发生率没有产生有利影响，这可能是由于极不成熟婴儿的存活率增加。在一项大型试验中，已经表明通过给予咖啡因可以减少 BPD 而没有不良反应。避免在复苏时使用高氧浓度也是一种有前途的方法，可以降低 BPD 的发生率。
