Management of bronchopulmonary dysplasia in Japan: A nationwide survey

Abstract

BackgroundThe incidence of bronchopulmonary dysplasia (BPD) and respiratory management practices for extremely low birth weight infants (ELBWIs) widely vary among institutions and countries. AimsTo clarify the variation and characteristics of the current practices of Japanese neonatologists managing patients with BPD. Study designQuestionnaire-based survey. ParticipantsLevel II and III perinatal centers certified by the Japan Society of Perinatal and Neonatal Medicine. Outcome measuresPolicies of the neonatal intensive care units (NICUs) regarding respiratory care and medications for BPD prevention and treatment. ResultsA total of 76 % of facilities (207/274) responded to our survey. The response rates of level III and II facilities were 91 % (102/112) and 35 % (105/296), respectively. INtubation-SURfactant-Extubation and Less Invasive Surfactant Administration methods were performed in 23 % (47/206) and 1 % (3/206) of facilities, respectively. For the prophylactic purpose, systemic and inhaled steroids were administered “frequently” or “occasionally” in 14 % (28/205) and 42 % (86/204) of NICUs, respectively. For the therapeutic purpose, systemic and inhaled steroids were administered “frequently” or “occasionally” in 84 % (171/204) and 29 % (59/204) of NICUs, respectively. Approximately half of the NICUs (99/202) used volume-targeted ventilation (VTV) “frequently” or “occasionally” in progressing BPD. High-frequency oscillation ventilation (HFOV) was used for progressing BPD “frequently” and “occasionally” in 89 % (180/202) of the facilities. ConclusionsOur study provided an overview and characteristics of BPD management in Japan in recent years. Noninvasive approaches with surfactant administration remain not widely used in Japan. HFOV is a widely accepted management for progressing BPD.