ABSTRACT
Nearly 30 years have passed since Northway and his colleagues provided the first clinical, radiologic, and pathological description of the chronic lung disease known as bronchopulmonary dysplasia (BPD; 228). BPD refers to the chronic lung disease of infancy that follows ventilator and oxygen therapy for neonatal respiratory distress syndrome (RDS). It was originally defined by the presence of chronic respiratory signs, abnormal chest radiographs, and persistent oxygen requirements beyond 1 month of age in newborn infants who have received intensive care. Although much has been learned about BPD since its initial description, the disease remains a ‘‘moving target,’’ as it continues to change with time. In comparison with the original report, most infants who acquire chronic lung disease are smaller and less mature at birth, with birthweight less than 1000 g in 75% of cases (149,228,231). The ‘‘classic’’ clinical, radiologic, and pathological stages of BPD are often absent now because of changes in perinatal management, including the use of antenatal and postnatal steroids, surfactant therapy, improved fluid management, new ventilator strategies, and better nutritional support (9,25,40,54,70,71,149,231). As a result, the term ‘‘chronic lung disease (CLD) of infancy’’ has either replaced or is often used interchangeably with ‘‘BPD’’
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as a diagnosis in many centers. Although recognizing the changing pattern of CLD from its initial descriptions, the terms BPD and CLD are used synonymously in this chapter to describe the chronic respiratory disease that often develops in neonates who are born prematurely.
