Columbus, OH — August 2017
While this article was originally published in 2017, the guide was updated in October 2019. The information below reflects the update.
Prevention of bronchopulmonary dysplasia (BPD) is a primary focus of treatment when an infant is born preterm. An infant who needs ventilator support does best with low tidal volumes and short inspiratory times to try and prevent lung injury during the acute course of lung disease.
However, once lung injury has occurred and the patient is diagnosed with BPD, some patients are still taken care of as if they have acute lung disease, says Leif Nelin, MD, chief of the Division of Neonatology at Nationwide Children’s Hospital and a founder of the national Bronchopulmonary Dysplasia Collaborative. In fact, ventilator strategies and settings must change dramatically after severe BPD is established.
The collaborative has published a review of best practices for the interdisciplinary care of children with severe BPD, and included recommendations for ventilator and gas exchange strategies. This chart provided is a guide, adapted from those recommendations and current clinical practice at Nationwide Children’s Hospital.
Abman SH, Collaco JM, Shepherd EG, Keszler M, Cuevas-Guaman M, Welty SE, Truog WE, McGrath-Morrow SA, Moore PE, Rhein LM, Kirpalani H, Zhang H, Gratny LL, Lynch SK, Curtiss J, Stonestreet BS, McKinney RL, Dysart KC, Gien J, Baker CD, Donohue PK, Austin E, Fike C, Nelin LD. Interdisciplinary care of children with severe bronchopulmonary dysplasia. The Journal of Pediatrics. 2017 Feb; 181:12-28.