Department of Pediatrics, Division of Pediatric Pulmonology, Weill Cornell Medicine, Komansky Children's Hospital, New York, NY, United States.
NewYork-Presbyterian Food& Nutrition Services, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, NY, United States.
Semin Perinatol. 2023 Oct;47(6):151818. doi: 10.1016/j.semperi.2023.151818. Epub 2023 Sep 9.
Premature births account for over 10% of live births worldwide. Bronchopulmonary dysplasia (BPD) represents a severe sequela in neonates born very prematurely and remains the most common chronic neonatal lung disease, often leading to serious adverse consequences in adulthood. Nutrition plays a crucial role in lung development and repair. Ongoing research has primarily focused on the pathogenesis and prevention of BPD in preterm birth. However, infants with established BPD need specialist medical care that persists throughout their hospitalization and continues after discharge. This manuscript aims to highlight the impact of growth and nutrition on BPD and highlight research gaps to provide direction for future studies. Protective practices include ensuring adequate early energy delivery through parenteral nutrition and enteral feedings while carefully monitoring total fluid intake and the use of breast milk over formula. These nutritional strategies remain the same for infants with established BPD with the addition of limiting the use of diuretics and steroids; but if employed, monitoring carefully without compromising total energy delivery. Functional nutrient supplements with a potential protective role against BPD are revisited, despite the limited evidence of their efficacy, including vitamins, trace elements, zinc, lipids, and sphingolipids. Planning post-intensive care and outpatient longitudinal nutrition support is critical in caring for an infant with established BPD.
早产儿占全球活产儿的 10%以上。支气管肺发育不良（BPD）是极早产儿出生后的严重后遗症，也是最常见的慢性新生儿肺部疾病，常导致成年后出现严重不良后果。营养在肺发育和修复中起着至关重要的作用。目前的研究主要集中在早产儿 BPD 的发病机制和预防上。然而，患有 BPD 的婴儿需要接受专门的医疗护理，这种护理在住院期间持续，并在出院后继续。本文旨在强调生长和营养对 BPD 的影响，并突出研究空白，为未来的研究提供方向。保护措施包括通过肠外营养和肠内喂养确保早期充足的能量供应，同时仔细监测总液体摄入和母乳与配方奶的使用。对于已经患有 BPD 的婴儿，这些营养策略是相同的，此外还需要限制利尿剂和类固醇的使用；但如果使用，应在不影响总能量供应的情况下仔细监测。尽管功能性营养素补充剂在预防 BPD 方面的疗效证据有限，但仍对其进行了回顾，包括维生素、微量元素、锌、脂质和鞘脂。规划重症监护后和门诊的纵向营养支持对于患有 BPD 的婴儿的护理至关重要。
