title: Progress in discovery and evaluation of treatments to prevent bronchopulmonary dysplasia.
abstract: BACKGROUND
  Recent improvements in the survival of extremely preterm infants have been accompanied by evolution in the pathogenesis and histopathology of bronchopulmonary dysplasia (BPD). Although oxygen and barotrauma-induced injury remain important contributing factors, pulmonary developmental arrest appears to play an equally important causal role in prolonged respiratory illness, especially among the most immature surviving preterm newborns. To date, clinical trials have failed to demonstrate a substantial benefit of a single treatment or preventive strategy for BPD.
  
  
  OBJECTIVE
  To evaluate the current evidence in favor of treatments that might prevent BPD.
  
  
  METHODS
  Review of clinical studies of preventive treatment strategies for BPD.
  
  
  RESULTS
  High frequency oscillatory ventilation, permissive hypercapnea, and inhaled nitric oxide might offer benefit to infants at risk of BPD. These and other potential preventive therapies for BPD, such as superoxide dismutase, inositol, and alpha(1)-proteinase inhibitor, deserve further study.
  
  
  CONCLUSIONS
  Although some current treatments offer promise, no preventive therapy for BPD has proven safe and effective, except for intramuscular vitamin A. Additional studies of respiratory technologies, management strategies, and protective molecules are needed.
authors.affiliation: Children's Hospital, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass., USA. linda.vanmarter@childrens.harvard.edu
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Van Marter
mesh_terms: D000818:Animals; D000975:Antioxidants / Q000378:metabolism; D001997:Bronchopulmonary Dysplasia / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control* / Q000628:therapy*; D045422:Continuous Positive Airway Pressure; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D011480:Protease Inhibitors / Q000627:therapeutic use
chemical_list: D000975:Antioxidants; D005938:Glucocorticoids; D011480:Protease Inhibitors