title: The preterm lung and airway: past, present, and future.
abstract: The tremendous advancement that has occurred in neonatal intensive care over the last 40-50 years can be largely attributed to greater understanding of developmental pathobiology in the newborn lung. Nonetheless, this improved survival from respiratory distress syndrome has been associated with continuing longer-term morbidity in the form of bronchopulmonary dysplasia (BPD). As a result, neonatal lung injury is a renewed focus of scientific interest. The onset of such an injury may begin in the delivery room, and this has generated interest in minimizing oxygen therapy and aggressive ventilatory support during the transition from fetal to neonatal lung. Fortunately, antenatal steroid therapy and selective use of surfactant therapy are now widely practiced, although fine tuning of this therapy for selected populations is ongoing. Newer therapeutic approaches address many aspects of BPD, including the pro-inflammatory component that characterizes this disorder. Finally, there is a greater need to understand the epidemiology and pathogenesis of the longer-term respiratory morbidity, most notably asthma, that persists in the preterm survivors of neonatal intensive care.
authors.affiliation: Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA. rxm6@case.edu
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Martin
authors.forename: Avroy A
authors.initials: AA
authors.lastname: Fanaroff
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D002110:Caffeine / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D011175:Positive-Pressure Respiration / Q000379:methods; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D011663:Pulmonary Surfactants; D002110:Caffeine
keywords: bronchopulmonary dysplasia; neonatal lung injury; neonatal respiratory therapy