Medicine | Quality of evidence | Recommendation |
Surfactant | Surfactant has been given to infants with evolving or established BPD only in nonrandomised trials (low) | Further studies are required |
Corticosteroids | Corticosteroids after age 3 weeks reduce oxygen dependence and late rescue steroid therapy, but have short-term adverse effects (high) | Corticosteroids should not be routinely used, but reserved for infants who cannot be weaned from mechanical ventilationUse lowest and shortest dose possible |
Diuretics | Despite short-term improvements in lung mechanics, diuretics do not show subsequent benefit in BPD treatment (high) | Diuretics should not be used routinely, but reserved for infants with fluid overload |
Bronchodilators | Administration in infants with BPD improves lung mechanics (moderate) | Bronchodilators should probably be used in wheezing infants, but only continued if there is clinical improvement |
Pulmonary vasodilators | Pulmonary vasodilators decrease pulmonary artery pressure, and iNO may improve oxygenation (low) | There is insufficient evidence to recommend the routine use of pulmonary vasodilators or iNO in infants with BPD |
iNO: inhaled nitric oxide.