Is chronic lung disease preventable?

Is chronic lung disease preventable?

H. Aly and M. Mohamed in their 2020 article in Pediatrics Research described a bubble CPAP bundle that is associated with a consistently low incidence of chronic lung disease over 16 years. This bundle included:
  • Specific protocol for delivery room management
  • Early use of bubble CPAP
  • Judicious use of surfactant
  • Criteria for bubble CPAP failure
  • Protocol for the care of airway
  • Weaning off CPAP
  • Use of caffeine
  • Monitoring oxygen saturation
  • Fluid and nutrition management
  • Transfusion practices.
They reported their results of 773 infants (median GA = 28 weeks, average BW = 995 g), where 24.5% of them were intubated in delivery room and 11.7% in the first day of life. Their CLD incidence was 6.4% that remained consistent over four chronological epochs (7.6%, 7.5%, 5.8% and 5%). They concluded that it is feasible and sustainable to administer similar bubble CPAP bundles to decrease CLD. Aly, H., Mohamed, M.A. An experience with a bubble CPAP bundle: is chronic lung disease preventable?. Pediatr Res (2020)