European Respiratory Society issues guidelines for long-term management of pediatric BPD

  • Duijts L & al.
  • Eur Respir J
  • 1 Jan 2020

  • International Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • The European Respiratory Society (ERS) convened experts to review the evidence and develop major consensus recommendations for managing bronchopulmonary dysplasia (BPD).
  • Also called chronic lung disease of prematurity, this chronic respiratory disease largely affects children born very preterm.
  • Guidelines are aimed at infants/children discharged from hospital, or children >36 weeks postmenstrual age.

Why this matters

  • There are no existing recommendations for this pediatric population.

Study design

  • Literature review and evaluation of evidence quality by Grading of Recommendations, Assessment, Development and Evaluation.
  • Funding: ERS.

Key recommendations

  • Monitor patients with ionizing radiation for lung imaging only in certain subgroups of patients (e.g., severe BPD, severe respiratory symptoms, etc).
  • Monitor lung function of all patients, usually with spirometry.
  • Give personalized advice about whether children should attend daycare.
  • Bronchodilator treatment may be used only for subgroups, such as severe BPD, severe respiratory or asthma-like symptoms, recurrent hospital admission, exercise intolerance, etc.
  • No treatment with inhaled or systemic corticosteroids, unless regular use is warranted by clinician discretion.
  • Natural weaning of diuretics as infants gain weight; use of diuretics in other infants/children by clinician discretion.
  • Supplemental oxygen with a saturation target of 90%-95%.

Limitations

  • Quality of evidence very low for all but 1 recommendation: the quality of evidence is low for recommendation against corticosteroids.