Respiratory Practices to Prevent or Treat Evolving Bronchopulmonary Dysplasia: A European Survey

Year: 2026

Type: article

Abstract: Objective To investigate respiratory practices to prevent or treat evolving bronchopulmonary dysplasia in neonatal intensive care units (NICUs) across Europe. Study design Between March and July 2024, a web-based survey was sent to European NICUs caring for infants born preterm with gestational age <28 weeks. Results We received replies from 447 of 721 (62%) NICUs across 24 European countries. Almost 16% of NICUs routinely intubate at birth, especially if the gestational age is <24 weeks. During transition most NICUs use continuous positive airway pressure ≥5 cmH 2 O and start with an FiO 2 0.3. Volume-targeted ventilation is the primary ventilation mode in 60% of the NICUs. Permissive hypercapnia is a common practice. Higher SpO 2 target limits have been adopted, although alarm settings vary across NICUs. Caffeine is routinely started (96%). Surfactant is used in all NICUs, mostly rescue (74%) via less invasive administration (81%). Prophylactic inhaled nitric oxide is not used. Treatment of patent ductus arteriosus varies; half of NICUs pharmacologically treat patent ductus arteriosus early, based on echocardiographic findings. Ureaplasma screening is done in 22% of NICUs. Most (97%) NICUs use postnatal corticosteroids, with dexamethasone being the preferred drug (65%) and starting 2-3 weeks after birth. Only 5% use corticosteroids prophylactically. After 2-3 weeks, diuretics are used frequently, inhaled corticosteroids/bronchodilators to a much lesser extent. Conclusions This large survey shows considerable practice variation in preventing and treating evolving bronchopulmonary dysplasia across Europe, especially for interventions with limited evidence.

Source: The Journal of Pediatrics

DOI: 10.1016/j.jpeds.2026.115006

Institutions: Emma Kinderziekenhuis, Amsterdam University Medical Centers, Amsterdam Reproduction Development, University of Amsterdam, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Copenhagen, Copenhagen University Hospital, Hospital Clínic de Barcelona, Universität Ulm, University Hospital Ulm, Sağlık Bilimleri Üniversitesi, İstanbul Başakşehir Çam ve Sakura Şehir Hastanesi, Poznan University of Medical Sciences, Hôpital Necker-Enfants Malades, Université Paris Cité, Hospital de São João, Medical University of Vienna, University of Turku, Turku University Hospital, University of California, San Francisco, UCLouvain, North Bristol NHS Trust, Southmead Hospital, University of Bristol, University of Oxford, Universitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș, Comenius University Bratislava, University of Patras, Tel Aviv University, Mayanei Hayeshua Medical Center, University Hospital Centre Zagreb, University of Zagreb, University of Freiburg, University Medical Center Freiburg, University Hospital Leipzig, Leipzig University, Karolinska University Hospital, Karolinska Institutet, University Children’s Hospital Basel, Charles University, Lithuanian University of Health Sciences, University College Dublin, National Maternity Hospital, University Hospital of North Norway, UiT The Arctic University of Norway, Uppsala University

Language: English

Topic: Neonatal Respiratory Health Research

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,570

Funder: European Maritime and Fisheries Fund

OpenAlex ID: W7125406663