Multidisciplinary bronchopulmonary dysplasia care

ABSTRACT

Introduction

Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease in neonates and infants, which often presents with multisystem organ involvement, co-morbidities, and prolonged hospital stays. Therefore, a multidisciplinary chronic care approach is needed in the severest forms of BPD to optimize outcomes. However, this approach can be challenging to implement. The objective of this article is to review and synthesize the available literature regarding multidisciplinary care in infants and children with established BPD, and to provide a framework that can guide clinical practice and future research.

Areas covered

A literature search was conducted using Ovid MEDLINE, CINAHL, and Embase and several components of multidisciplinary management of BPD were identified and reviewed, including chronic care, team development, team members, discharge planning, and outpatient care.

Expert opinion

Establishing a core multidisciplinary group familiar with the chronicity of established BPD is recommended as best practice for this population. Acknowledging this is not feasible for all individual centers, it is important for clinical practice and future research to focus on the development and incorporation of national consulting services, telemedicine, and educational resources.

KEYWORDS:

• Infant
• chronic lung disease
• neurodevelopment
• nutrition
• mechanical ventilation

Article highlights

• BPD is a multifactorial disease with multisystem involvement, and the co-morbidities in this population necessitate the involvement of multiple specialists dedicated to the care of infants with established BPD, both in the inpatient and outpatient settings.

• A multidisciplinary chronic care approach to BPD management is associated with improved short- and long-term outcomes, improved healthcare resource utilization, and family-centered care.

• Patients with BPD benefit from a chronic care approach over an acute care approach, and more information is needed to determine what age and location is most appropriate to optimally achieve this transition of care.

• Many challenges exist to obtaining a multidisciplinary chronic care approach to BPD management, including finances, time, hospital leadership support, limited patient volume, and subspecialties with an interest in BPD.

• There is a need for future clinical practice and research to focus on how to best implement and sustain multidisciplinary chronic care to provide optimal outcomes for patients with established BPD.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.