Bronchopulmonary dysplasia (BPD), the major chronic lung disease of infancy, affects approximately half of infants born at ≤28-weeks gestation and persists as a leading cause of mortality and respiratory impairments among preterm infants. BPD is commonly measured at 36-weeks post menstrual age, the age at which BPD severity predicts pulmonary disease and long term neurodevelopmental delay. Safe, proven treatments for BPD are extremely limited however, leading many clinicians to prescribe unproven, off-label treatments including diuretics and inhaled corticosteroids (ICS). These treatments are controversial in that their effectiveness to treat evolving and established BPD is not proven, thus putting these infants at risk for harmful side effects. Previous randomized trial studies for these BPD treatments showed no benefit but were severely limited in sample size and number of trials.
In the present study, we aim to utilize patient data from multiple sites to determine whether diuretic and inhaled corticosteroid treatment will reduce mortality and severity of BPD in preterm infants as compared to no treatment. We hope that this will influence clinician management and aid future prospective investigations. Furthermore, this investigation targets the preterm infant population and this determination will have the positive effects of improving patient outcomes in this vulnerable population, limiting unnecessary, damaging, side effects, and guiding clinician decisions for safe, effective treatments for BPD.