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. 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.
While progress has been made in the treatment and prevention of BPD, the prevalence has not decreased. Hydrocortisone’s mineralocorticoid and glucocorticoid properties are beneficial in decreasing inflammatory processes that may be harmful to the developing lung. Studies indicate that hydrocortisone improves BPD-free survival and may decrease ventilation time. Hydrocortisone appears to be a safer alternative to dexamethasone, which historically demonstrated efficacy in the prevention of BPD, but was associated with short- and long-term adverse effects that may outweigh its benefit.