Pharmacological approaches to the therapy of chronic lung disease in the newborn

Bronchopulmonary dysplasia (BPD) is a chronic lung disease that develops in newborn infants treated with oxygen and mechanical ventilation. With significant improvements in survival of many critically ill infants, BPD has become an extremely important sequela of neonatal intensive care. Treatment of BPD is similar to childhood asthma, since the pathophysiological abnormalities are comparable. Inspired oxygen and positive pressure mechanical ventilation are needed until the infant's cardiorespiratory condition has stabilized and the therapy can be slowly and safely withdrawn. Many different medications are also used often concurrently. Systemic and inhaled bronchodilators and diuretics are used to improve clinical pulmonary status. In more severe cases, short tapering courses of systemic corticosteroids can be associated with profound clinical improvements. Ultimately, attention must be directed toward the prevention of BPD. Many new therapeutic interventions are currently being developed which may prevent or significantly ameliorate this important problem.