TY - JOUR T1 - European Respiratory Society guideline on long term management of children with bronchopulmonary dysplasia JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00788-2019 SP - 1900788 AU - Liesbeth Duijts AU - Evelien R. van Meel AU - Laura Moschino AU - Eugenio Baraldi AU - Magda Barnhoorn AU - Wichor M. Bramer AU - Charlotte E. Bolton AU - Jeanette Boyd AU - Frederik Buchval AU - Maria Jesus del Cerro AU - Andrew A. Colin AU - Refika Ersu AU - Anne Greenough AU - Christiaan Gremmen AU - Thomas Halvorson AU - Juliette Kamphuis AU - Sailesh Kotecha AU - Kathleen Rooney-Otero AU - Sven Schulzke AU - Andrew Wilson AU - David Rigau AU - Rebecca L. Morgan AU - Thomy Tonia AU - Charles C. Roehr AU - Marielle W. Pijnenburg Y1 - 2019/01/01 UR - http://erj.ersjournals.com/content/early/2019/09/19/13993003.00788-2019.abstract N2 - This document provides recommendations for monitoring and treatment of children in whom bronchopulmonary dysplasia (BPD) has been established and were discharged from the hospital, or who were older than 36 weeks of postmenstrual age. The guideline was based on pre-defined 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 day care attendance. With regards to treatment, we suggest to use 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 to treat 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.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Duijts has nothing to disclose.Conflict of interest: Dr. van Meel has nothing to disclose.Conflict of interest: Dr. Moschino has nothing to disclose.Conflict of interest: Dr. Baraldi has nothing to disclose.Conflict of interest: Dr. Barnhoorn has nothing to disclose.Conflict of interest: Dr. Bramer has nothing to disclose.Conflict of interest: Dr. Bolton has nothing to disclose.Conflict of interest: Jeanette Boyd has nothing to disclose.Conflict of interest: Dr. Colin has nothing to disclose.Refika ErsuConflict of interest: Dr. Greenough reports grants and other from MedImmune/ Abbott, outside the submitted work; .Christiaan GremmenConflict of interest: Dr. Kamphuis has nothing to disclose.Sailesh KotechaConflict of interest: Dr. Rooney-Otero has nothing to disclose.Conflict of interest: Dr. Schulzke has nothing to disclose.Conflict of interest: Dr. Wilson has nothing to disclose.Conflict of interest: Dr. Rigau reports and declares he works as methodologist of the ERS.Conflict of interest: Dr. Morgan has nothing to disclose.Conflict of interest: Ms Tonia reports acting as ERS Methodologist.Conflict of interest: Dr. Roehr has nothing to disclose.Conflict of interest: Dr. Pijnenburg has nothing to disclose.Conflict of interest: Dr. HALVORSEN has nothing to disclose.Conflict of interest: Dr. Buchvald has nothing to disclose.Conflict of interest: Dr. Jesus del Cerro has nothing to disclose. ER -