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BPD

From Bronchopulmonary Dysplasia to Chronic Obstructive Pulmonary Disease: A Developmental Continuum
 From Bronchopulmonary Dysplasia to Chronic Obstructive Pulmonary Disease: A Developmental Continuum 1024 774 Yan Hu, PhD
By: Yan Hu, PhD
Blue-toned illustration showing lungs beside silhouettes of people across the lifespan, from a crawling baby and toddler to a child, adult, and older adult with a cane.

A Prolonged Window of Vulnerability Lung development is a highly orchestrated process that begins early in gestation and continues well into postnatal life. Following airway branching during the embryonic and pseudoglandular stages, distal lung maturation, including small airway and alveolar formation, extends through infancy and early childhood. This prolonged developmental window renders the lung particularly…

Bronchopulmonary Dysplasia Research: Innovating on All Fronts
 Bronchopulmonary Dysplasia Research: Innovating on All Fronts 1024 509 JoAnna Pendergrass, DVM
By: JoAnna Pendergrass, DVM
Newborn with bronchopulmonary dysplasia sleeping in a NICU crib, wrapped in a hospital blanket and receiving oxygen through a nasal cannula.

From understanding the disease at a molecular level to improving strategies for oxygen support after discharge, researchers are tackling bronchopulmonary dysplasia from all angles. The doctors in the Neonatal Intensive Care Unit at Nationwide Children’s Hospital care for more babies with bronchopulmonary dysplasia (BPD) than any other institution in the country. Their Comprehensive Center for …

Mode of Respiratory Support at 36 Weeks Predicts Weaning Timeline for Infants With Severe Bronchopulmonary Dysplasia
 Mode of Respiratory Support at 36 Weeks Predicts Weaning Timeline for Infants With Severe Bronchopulmonary Dysplasia 1024 683 Lauren Dembeck
By: Lauren Dembeck
Premature baby receiving respiratory support through a nasal cannula in a neonatal intensive care unit, monitored and cared for by a health care provider.

Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth, and its incidence is rising due to advances in neonatal care that have improved survival for extremely premature infants. Respiratory support is a cornerstone of management for these patients, yet the expected timeline for weaning in those with moderate-to-severe (grade 2/3) BPD is not…

Supporting Tracheostomy Decision-Making for Families and Providers
 Supporting Tracheostomy Decision-Making for Families and Providers 1024 683 Abbie Miller
By: Abbie Miller

The Trach Scoring Tool, developed by leaders in bronchopulmonary dysplasia (BPD) at Nationwide Children’s Hospital, offers support for physicians and families. The decision of when to do a tracheostomy on an infant is difficult, to say the least, says Leif Nelin, MD, division chief of Neonatology at Nationwide Children’s Hospital. “Every family has different knowledge,…

Higher Respiratory Severity Scores Associated with Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension Risk
 Higher Respiratory Severity Scores Associated with Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension Risk 1024 683 Mary Bates, PhD
By: Mary Bates, PhD

The RSS score is noninvasive and may be clinically useful for risk stratification in extremely preterm infants. Researchers at Nationwide Children’s report that elevations in the respiratory severity score were correlated with an increased risk of bronchopulmonary dysplasia-associated pulmonary hypertension in preterm infants. This study identifies a pragmatic clinical risk score that can be measured…

Using Machine Learning to Classify Treatment Approaches for Infants with Bronchopulmonary Dysplasia
 Using Machine Learning to Classify Treatment Approaches for Infants with Bronchopulmonary Dysplasia 1024 683 Pam Georgiana
By: Pam Georgiana

We don’t yet know the best way to help infants with severe bronchopulmonary dysplasia (BPD) breathe using ventilators. Currently, doctors across the country and around the world use a variety of different approaches.  These variations depend on the severity of a patient’s medical condition, the ventilator settings used, and location-specific standards. Matthew Kielt, MD, a…

Assessing Respiratory Stability in Infants Hospitalized with Bronchopulmonary Dysplasia
 Assessing Respiratory Stability in Infants Hospitalized with Bronchopulmonary Dysplasia 1024 683 Mary Bates, PhD
By: Mary Bates, PhD

The Behavioral Signs of Respiratory Instability Scale is a valid, reliable measure of respiratory status and developmental ability. In a new study, researchers at Nationwide Children’s evaluated the Behavioral Signs of Respiratory Instability (BSRI) Scale, which was developed as an objective measure of developmental capacity of infants with severe forms of bronchopulmonary dysplasia (BPD). The…

Predicting Response to Bronchodilators in Infants with Bronchopulmonary Dysplasia
 Predicting Response to Bronchodilators in Infants with Bronchopulmonary Dysplasia 1024 683 Mary Bates, PhD
By: Mary Bates, PhD

Study emphasizes importance of identifying those patients who will respond to treatment. Certain pulmonary function test parameters in newborns with bronchopulmonary dysplasia are associated with bronchodilator response, according to a new study from researchers at Nationwide Children’s Hospital. The team also found that responders had evidence of greater dysanaptic lung growth than nonresponders. Bronchodilators are…

Is Tracheostomy Tube Placement in Preemies Safe?
 Is Tracheostomy Tube Placement in Preemies Safe? 1024 575 Mary Bates, PhD
By: Mary Bates, PhD
Nurse caring for infant in Neonatal Intensive Care Unit (NICU)

The procedure is safe and effective in newborns requiring high ventilator pressures. Tracheostomy tube placement is a common procedure performed for premature infants requiring respiratory assistance. Compared to an endotracheal tube, placement of a tracheostomy tube is thought to allow the infant more opportunities for comfort, interaction, nutrition and growth. However, rates of tracheostomy tube…

Specialized Treatment for Severe Bronchopulmonary Dysplasia Increases Survival
 Specialized Treatment for Severe Bronchopulmonary Dysplasia Increases Survival 1024 683 Mary Bates, PhD
By: Mary Bates, PhD
Dr. Edward Shepherd

Most infants with established BPD referred to Nationwide’s BPD Center improve and survive, despite the severity of their illness. In a new study, researchers analyzed the in-hospital outcomes for preterm infants with established bronchopulmonary dysplasia (BPD) referred to Nationwide Children’s Comprehensive Center for BPD. They found that despite the high degree of illness severity in…

Bronchopulmonary Dysplasia: Characterizing the Chronic Lung Disease of Prematurity
 Bronchopulmonary Dysplasia: Characterizing the Chronic Lung Disease of Prematurity 1024 575 Lauren Dembeck
By: Lauren Dembeck
Nurse caring for infant in Neonatal Intensive Care Unit (NICU)

  Precise definitions and/or classifications of bronchopulmonary dysplasia are needed to optimize outcomes. Researchers at Nationwide Children’s Hospital are continuing to help refine the definition of severe bronchopulmonary dysplasia (sBPD). In a recent study, members of the BPD Collaborative demonstrated that preterm infants with sBPD who were on invasive mechanical ventilation at 36 weeks, a…

No Evidence Supporting Prophylactic Indomethacin Treatment for Most Preterm Infants
 No Evidence Supporting Prophylactic Indomethacin Treatment for Most Preterm Infants 1024 575 Lauren Dembeck
By: Lauren Dembeck
Nurse caring for infant in Neonatal Intensive Care Unit (NICU)

Inconsistency among studies prompted researchers to take a closer look at the drug’s effects. Despite limited evidence supporting its use, prophylactic indomethacin treatment is often administered to very preterm infants within the first 24-hours after birth to reduce the risks of intraventricular hemorrhage and longer-term neonatal morbidities, such as bronchopulmonary dysplasia (BPD). Data from a…

Timing Steroids to Maximize Lung Benefit and Avoid Brain Harm in Premature Infants
 Timing Steroids to Maximize Lung Benefit and Avoid Brain Harm in Premature Infants 1024 575 Mary Bates, PhD
By: Mary Bates, PhD
Nurse caring for infant in Neonatal Intensive Care Unit (NICU)

Treating infants early may decrease risk of lung disease with no added risk of neurodevelopmental impairment. Steroids are used to treat extremely premature babies with respiratory failure, yet they can be associated with delays in brain development. A recent study looked at the age of first steroid administration and the risks of lung disease and neurodevelopmental impairment…

Prediction of Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension by Combining Clinical and Genetic Data
 Prediction of Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension by Combining Clinical and Genetic Data 150 150 Lauren Dembeck
By: Lauren Dembeck

Best Practices in Severe BPD Treatment
 Best Practices in Severe BPD Treatment 150 150 Jeb Phillips
By: Jeb Phillips

To help standardize care, the Bronchopulmonary Dysplasia Collaborative has published a comprehensive review of evidence-based approaches for treatment of patients with severe forms of the disease. Infants with severe bronchopulmonary dysplasia (BPD) have high risks of late morbidities and mortality, but the best ways to manage these vulnerable patients are still debated. In fact, it’s…

Stress Dose Hydrocortisone Effects on Neurodevelopment for Extremely Low Birthweight Infants
 Stress Dose Hydrocortisone Effects on Neurodevelopment for Extremely Low Birthweight Infants 150 150 Abbie Miller
By: Abbie Miller

First placebo-controlled study on stress dose hydrocortisone and neurodevelopment shows that higher doses of hydrocortisone are not associated with brain injury or neurodevelopmental impairments, but may not be effective in reducing risk for bronchopulmonary dysplasia. Hydrocortisone is one of the 15 most frequently prescribed medications in extremely low birth weight (≤1000 g) infants in the…

Reducing Practice Variation in Pediatrics
 Reducing Practice Variation in Pediatrics 150 150 Jonathan Slaughter, MD, MPH
By: Jonathan Slaughter, MD, MPH

With variations in practice existing even between practitioners at the same institution, research can provide the keys to standardizing care and improving outcomes. Practice variation occurs when care providers diagnose or treat patients differently, even in the setting of similar disease presentation and risk factors. Variations in care have been noted at the geographic level…