The Role of Hydrocortisone in the Management of Bronchopulmonary Dysplasia

Emily Monds, PharmD


Pediatr Pharm. 2016;22(12) 

In This Article

Abstract and Introduction


Although the clinical landscape of bronchopulmonary dysplasia (BPD) has shifted over the years, BPD remains the most common form of chronic lung disease in infants.[1] Historically BPD was seen in preterm infants who had suffered vasotrauma from aggressive mechanical ventilation. With advancements in medical care and the resultant survival of extremely premature infants delivered during the late canalicular and early saccular stage of lung development, today's BPD has become more of a developmental disorder.[1,2]

Low cortisol levels in premature infants have correlated to increased severity of illness, mortality, and subsequent development of BPD, thus leading to the proposed option of glucocorticoids for prevention and treatment of BPD.[3] However, mixed results from clinical studies combined with their potential for neurologic adverse events have created controversy around their use in the neonatal population. Despite this fact, hydrocortisone is one of the 15 most frequently prescribed medications in extremely low birth weight (ELBW) infants in neonatal intensive care units and is a continued topic of study and discussion.[4]