BPD Collaborative

The BPD Collaborative was formed to fill knowledge gaps around the care of infants with bronchopulmonary dysplasia (BPD) improving care and outcomes of patients with established severe BPD.

The mission of the BPD Collaborative is to serve as a catalyst for improving the life-long outcomes of babies who develop severe BPD by fostering interdisciplinary collaboration and innovation in the identification and treatment of these highly vulnerable patients.

We accomplish this through:

  • Sharing data

  • Developing and implementing quality improvement initiatives

  • Fostering research protocols to address the most pressing gaps in our knowledge

BPD Collaborative Institutions

The BPD Collaborative is comprised of institutions with multidisciplinary teams dedicated to optimizing outcomes of infants and children with severe BPD. We support the concept of BPD prevention in preterm infants.

The BPD Collaborative includes 12 institutions: 

Other organizations and groups are currently working on BPD prevention. The focus of the BPD Collaborative is improving the outcomes of patients who have established severe BPD.

What is Severe Bronchopulmonary Dysplasia? 

Bronchopulmonary dysplasia (BPD) is a chronic lung disease that follows neonatal intensive care for babies born preterm. Improved obstetrical and neonatal care over time has increased survival of even the smallest of preterm babies, but BPD continues to be a major problem with estimates of 10,000 – 15,000 new cases per year in the United States.

Although marked improvements in perinatal care have led to milder respiratory courses for most preterm infants, infants with BPD can still develop severe chronic respiratory failure and marked cardiopulmonary impairment. The current NIH classification system defines severe BPD as the need for supplemental oxygen with an FiO2 ≥ 0.30 and/or mechanical ventilation or continuous positive airway pressure at 36 weeks corrected age.

Data from the National Institutes of Health Neonatal Research Network suggest that severe BPD develops in roughly 16% of infants who are born at <32 weeks. Infants with severe BPD have complicated clinical courses, which can include prolonged need for ventilator and respiratory support, tracheostomy, recurrent pneumonias and respiratory exacerbations, pulmonary hypertension, neurodevelopmental problems, and other related issues.  

Caring for Infants with Severe BPD

The strategies for the successful management of infants with severe BPD remain unclear; therefore, there are wide variations in practice.

Controversies regarding many aspects of clinical care persist, including:

  • Strategies of mechanical ventilation in established BPD

  • Identification of patients who could benefit from tracheostomy and prolonged ventilator support

  • Role for nasal CPAP therapy in older patients with BPD

  • Diagnostic evaluations of severe BPD

  • Assessments for reflux and aspiration

  • Pharmacologic management of BPD

  • Screening and treatment of pulmonary hypertension

Although traditionally cared for by neonatologists throughout the inpatient hospitalization, the complexity of severe BPD has led to the growth of multidisciplinary teams, including pediatric pulmonologists, nutritionists, physical therapists, social workers, occupational therapists, and more. Yet the organization and approach of such care programs are incompletely defined.  

Infants with severe BPD present persistent challenges and controversies in care, raising many questions and issues regarding optimal strategies for enhancing their long-term outcomes.

BPD Collaborative Publications

  • 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. 

  • Guaman MC, Gien J, Baker CD, Zhang H, Austin ED, Collaco JM. Point Prevalence, Clinical Characteristics, and Treatment Variation for Infants with Severe Bronchopulmonary Dysplasia. Am J Perinatol 2015; 32:960-967. PMID: 25738785 

  • Curtiss J, Zhang H, Griffiths P, Shepherd EG, Lynch S. Nutritional Management of the Infant with Severe Bronchopulmonary Dysplasia. NeoReviews 2015; 16: e674-e679.

BPD Collaborative Projects

  • Development of a registry for severe BPD

  • Corticosteroids and Severe BPD: Dose, Exposure, Response Modifiers

  • Weaning supplemental oxygen post-discharge in severe BPD patients

  • Out-patient care in severe BPD

  • Parent empowerment in severe BPD

  • Potential role for neuronally adjusted ventilatory assist (NAVA) in mechanically ventilated patients with severe BPD

  • Development of a national conference on the state-of-the-art in the care of the infant with severe BPD