Estrategias de Prevención y Tratamiento en Displasia Broncopulmonar

Abstract

ABSTRACT Strategies for Prevention and Treatment of Broncopulmonary Dysplasia Bronchopulmonary Dysplasia (BPD) continues to be a highly frequent sequela of low birth weight infants.This, despite the many recent advances in perinatal medicine that include antenatal steroids, exogenoussurfactant, new strategies for mechanical respiratory support, parenteral nutrition improvements and amore judicious use of supplemental oxygen. The purpose of this review is to analyze and describe therecent advances in the prevention and management of BPD. New preventive therapies have been developed,and vitamin A and caffeine administration have been shown to diminish the incidence of this disorder.Postnatal corticosteroids can also be useful, but due to their negative long-term neurological effects, thesemedications are not currently recommended. Corticosteroid administration in established BPD can decreasethe need for mechanical ventilation and improve lung function. Other preventive interventions such asantioxidant administration and nitric oxide inhalation are currently being investigated. The persistence ofthe ductus arteriosus is associated with increased risk of BPD, therefore early pharmacologic closure canplay a role in preventing this disorder. New modalities of mechanical ventilation, such as synchronized andhigh frequency ventilation, have not been shown to decrease the incidence of this disease. While adiscussion regarding the best type of ventilation to be used still remains, the consensus is that that thelowest inspiratory pressure and lowest oxygen concentration necessary should be utilized to maintainadequate gas exchange. Optimal level of arterial oxygen saturation in premature infants is still controversial,but the current recommended range is between 88% and 95%.