a Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London , UK.
b The Asthma UK Centre for Allergic Mechanisms in Asthma, King's College London , UK.
Expert Rev Respir Med. 2019 Aug;13(8):727-735. doi: 10.1080/17476348.2019.1637738. Epub 2019 Jul 2.
: Bronchopulmonary dysplasia (BPD) is a common long-term adverse complication of very premature delivery. Affected infants can suffer chronic respiratory morbidities including lung function abnormalities and reduced exercise capacity even as young adults. Many studies have investigated possible preventative strategies; however, it is equally important to identify optimum management strategies for infants with evolving or established BPD. : Respiratory support modalities and established and novel pharmacological treatments. : Respiratory support modalities including proportional assist ventilation and neurally adjusted ventilatory assist are associated with short term improvements in oxygenation indices. Such modalities need to be investigated in appropriate RCTs. Many pharmacological treatments are routinely used with a limited evidence base, for example diuretics. Stem cell therapies in small case series are associated with promising results. More research is required before it is possible to determine if such therapies should be investigated in large RCTs with long-term outcomes.
支气管肺发育不良(BPD)是极早早产的常见长期不良并发症。受影响的婴儿即使在成年后也可能患有慢性呼吸系统疾病,包括肺功能异常和运动能力下降。许多研究都探讨了可能的预防策略;然而,对于患有不断发展或已确诊的 BPD 的婴儿,确定最佳的管理策略同样重要。本文重点讨论了现有的和新的呼吸支持方式以及药物治疗方法。
呼吸支持方式,包括比例辅助通气和神经调节通气辅助,与短期改善氧合指数有关。需要在适当的 RCT 中对这些方式进行研究。许多药物治疗方法的应用有一定的局限性,例如利尿剂,其循证医学证据有限。在确定这些治疗方法是否应该在具有长期结局的大型 RCT 中进行研究之前,还需要进行更多的研究。在小型病例系列中,干细胞疗法与有希望的结果相关。