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Rigshospitalet - en del af Københavns Universitetshospital
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European Respiratory Society guideline on long-term management of children with bronchopulmonary dysplasia

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  • Liesbeth Duijts
  • Evelien R van Meel
  • Laura Moschino
  • Eugenio Baraldi
  • Magda Barnhoorn
  • Wichor M Bramer
  • Charlotte E Bolton
  • Jeanette Boyd
  • Frederik Buchvald
  • Maria Jesus Del Cerro
  • Andrew A Colin
  • Refika Ersu
  • Anne Greenough
  • Christiaan Gremmen
  • Thomas Halvorsen
  • Juliette Kamphuis
  • Sailesh Kotecha
  • Kathleen Rooney-Otero
  • Sven Schulzke
  • Andrew Wilson
  • David Rigau
  • Rebecca L Morgan
  • Thomy Tonia
  • Charles C Roehr
  • Marielle W Pijnenburg
Vis graf over relationer

This document provides recommendations for monitoring and treatment of children in whom bronchopulmonary dysplasia (BPD) has been established and who have been discharged from the hospital, or who were >36 weeks of postmenstrual age. The guideline was based on predefined Population, Intervention, Comparison and Outcomes (PICO) questions relevant for clinical care, a systematic review of the literature and assessment of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. After considering the balance of desirable (benefits) and undesirable (burden, adverse effects) consequences of the intervention, the certainty of the evidence, and values, the task force made conditional recommendations for monitoring and treatment of BPD based on very low to low quality of evidence. We suggest monitoring with lung imaging using ionising radiation in a subgroup only, for example severe BPD or recurrent hospitalisations, and monitoring with lung function in all children. We suggest to give individual advice to parents regarding daycare attendance. With regards to treatment, we suggest the use of bronchodilators in a subgroup only, for example asthma-like symptoms, or reversibility in lung function; no treatment with inhaled or systemic corticosteroids; natural weaning of diuretics by the relative decrease in dose with increasing weight gain if diuretics are started in the neonatal period; and treatment with supplemental oxygen with a saturation target range of 90-95%. A multidisciplinary approach for children with established severe BPD after the neonatal period into adulthood is preferable. These recommendations should be considered until new and urgently needed evidence becomes available.

OriginalsprogEngelsk
Artikelnummer1900788
TidsskriftEuropean Respiratory Journal
Vol/bind55
Udgave nummer1
Sider (fra-til)1900788
Antal sider17
ISSN0903-1936
DOI
StatusUdgivet - 2020

Bibliografisk note

Funding Information:
The chairs applied for a task force on BPD, which was approved and funded by the European Respiratory Society (ERS). The task force consisted of a multidisciplinary group of clinicians, scientific researchers, methodologists or patient representatives with expertise in the paediatric respiratory (n=11), neonatology (n=3), paediatric cardiology (n=1), adult respiratory (n=1), epidemiology (n=3) and patient involvement (n=4) fields related to long-term monitoring and treatment of children with BPD. All representatives had intensive experience in long-term follow-up of children born preterm or with BPD. Task force members were from Europe, the United States and Australia. Two junior members/trainees of the ERS, a parent of a patient with BPD, an adult patient with BPD and national (Lung Foundation Netherlands) and international (European Lung Foundation) patient representatives were active members of the committee. In addition, methodologists from the ERS provided expertise in guideline development following the GRADE approach. Potential conflicts of interest were disclosed and managed according to ERS policies.

Funding Information:
Support statement: The participants of the project received funding for travel and meetings from the European Respiratory Society (number TF-2015-18). Funding information for this article has been deposited with the Crossref Funder Registry.

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