Division of Neonatology, Department of Pediatrics, NYU Winthrop Hospital, 259 First Street, Mineola, NY 11501, United States.
Section of Neonatal-Perinatal Medicine, Department of Pediatrics, St. Christopher's Hospital for Children, Drexel University College of Medicine, 160 East Erie Avenue, Philadelphia, PA 19134, United States.
Semin Perinatol. 2018 Nov;42(7):444-452. doi: 10.1053/j.semperi.2018.09.006. Epub 2018 Oct 2.
Bronchopulmonary dysplasia (BPD) is a complex disorder with multiple factors implicated in its etiopathogenesis. Despite the scientific advances in the field of neonatology, the incidence of BPD has remained somewhat constant due to increased survival of extremely premature infants. Surfactant deficiency in the immature lung, exposure to invasive mechanical ventilation leading to volutrauma, barotrauma and lung inflammation are some of the critical contributing factors to the pathogenesis of BPD. Hence, strategies to prevent BPD in the postnatal period revolve around mitigation of this injury and inflammation. This article reviews the progress made in the last 5 years in the development of new preparations of surfactant, use of corticosteroids and non-invasive ventilation in the prevention of BPD. Emerging techniques of surfactant delivery through minimally invasive and non-invasive routes are also discussed.
支气管肺发育不良（BPD）是一种复杂的疾病，其发病机制涉及多种因素。尽管新生儿学领域取得了科学进步，但由于极早产儿的存活率增加，BPD 的发病率仍然保持相对稳定。未成熟肺中表面活性剂的缺乏、导致过度通气、气压伤和肺炎症的有创机械通气的暴露，是导致 BPD 发病机制的一些关键因素。因此，预防新生儿期 BPD 的策略围绕着减轻这种损伤和炎症。本文综述了过去 5 年在新型表面活性剂制剂的开发、皮质类固醇和无创通气在预防 BPD 中的应用方面取得的进展。还讨论了通过微创和无创途径输送表面活性剂的新技术。
