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The Bronchopulmonary Dysplasia Diagnosis: Definitions, Utility, Limitations

  • Roberta L. KellerEmail author
Chapter
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Part of the Respiratory Medicine book series (RM)

Abstract

The definition of bronchopulmonary dysplasia (BPD) has evolved over the past 40 years, as survival for extremely preterm infants has improved. Clinical definitions of BPD have eliminated the requirement for abnormal chest radiograph, depending only on the prescription of supplemental oxygen, and have generally transitioned from determination at 28 days of age to 36 weeks’ postmenstrual age. More detailed clinical definitions proposed a severity scale for BPD (in which infants on assisted ventilation are classified as severe BPD, regardless of receipt of supplemental oxygen). Other definitions of BPD that have been broadly adopted in observational and interventional research are based on a physiologic challenge conducted in infants on nasal cannula support or other forms of supplemental oxygen without assisted ventilation. The challenge assesses the ability of the infant to maintain a prespecified oxygen saturation with a gradual decrease and discontinuation of clinical respiratory support. Although physiologic and severity-based definitions of BPD likely provide more discrimination, validation studies of BPD with respect to outcomes defining respiratory morbidity at 1–2 years corrected age have predominantly been based on binary clinical definitions of BPD. Accuracy of prediction likely depends on patient population characteristics and the specific outcomes of interest.

Keywords

Benchmarking Clinical trials Extremely low gestational age newborn Prematurity Pulmonary function Respiratory morbidity 

Abbreviations

BPD

Bronchopulmonary dysplasia

FRC

Functional residual capacity

HHFNC

Humidified high flow nasal cannula

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Pediatrics/NeonatologyUCSF Benioff Children’s HospitalSan FranciscoUSA

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