Pathology of new bronchopulmonary dysplasia

Jacqueline J. Coalson

Research output: Contribution to journalReview article

346 Scopus citations

Abstract

Technological advances, improved ventilatory strategies and better nursing techniques, coupled with the use of prenatal steroids and postnatal surfactant, have resulted in the survival of smaller and more immature infants. Preterm infants likely to develop bronchopulmonary dysplasia (BPD) are born during the canalicular phase of lung development at 24-26 weeks, a time when alveolar and distal vascular development commences. The histopathologic lesions of severe airway injury and alternating sites of overinflation and fibrosis in 'old' BPD have been replaced in 'new' BPD with the pathologic changes of large, simplified alveolar structures, a dysmorphic capillary configuration and variable interstitial cellularity and/or fibroproliferation. Airway and vascular lesions, when present, tend to occur in infants who over time develop more severe disease. The alveolar and capillary hypoplasia of new BPD will require the development of specific therapies, but avoiding volutrauma, oxidant injury and inflammation/infection will improve lung morphology.

Original languageEnglish (US)
Pages (from-to)73-81
Number of pages9
JournalSeminars in Neonatology
Volume8
Issue number1
DOIs
StatePublished - Feb 2003

Keywords

  • Alveolar hypoplasia
  • Alveolization
  • Bronchopulmonary dysplasia
  • Capillary hypoplasia
  • Chronic lung disease
  • Developmental arrest
  • Lung development
  • Lung pathology

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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