BRONCHOPULMONARY DYSPLASIA

Bronchopulmonary dysplasia is defined as prolonged respiratory failure resulting from sequellae after neonatal intensive care in premature i nfants, Functional impairment continues into adult life, There are two main causal factors: the initial respiratory disease and pulmonary im maturity, Up through the nineties, bronchopulmonary dysplasia was a ma jor problem in neonatal intensive care units; mortality reached 20% of infants requiring artificial ventilation for 1 or 2 months, Despite t he rising rate of premature births (currently 2%) considerable progres s has been made in the treatment of bronchopulmonary dysplasia, The qu estion is whether the infants in the current generation with still suf fer into adult life, Advances in preventive therapy hare included ante natal corticosteroid therapy, use of exogenous surfactants and progres sive improvement in ventilatory assistance techniques, Improved neonat al care to relieve pain and maintain nutrition have also had an import ant effect, Specific treatments include the use of salbutamol spray to reduce bronchospasme and improve respiratory compliance, The initial hopes placed in inhaled corticosteroids were unfortunately recently sh own to be unfounded, Due to the large number of premature infants it a ppears difficult to predict the future situation of bronchopulmonary d ysplasia, but current data show a clear tendancy towards regression of the disease. Three preventive measures could further reduce the incid ence: better coordination between obstetricians and pediatricians, ext ension of antenatal corticosteroid therapy and the development and imp rovement of continuous positive pressure ventilation.