REVIEW
How has research in the past 5 years changed my clinical practice
Correspondence to:
Professor Anne Greenough, Deparment of Child Health, 4th Floor Golden Jubilee Wing, King’s College Hospital, London SE5 9RS, UK; anne.greenough{at}kcl.ac.uk
This article discusses how research in the past 5 years into management strategies influencing respiratory outcomes has changed (or not changed) the author’s clinical practice. Changes include using inhaled nitric oxide but no longer systemic pulmonary vasodilators in term born infants with pulmonary hypertension. Use of postnatal steroids is now restricted to systemic administration in infants with severe respiratory failure and who are ventilator dependent beyond 2 weeks of age. Infants with bronchopulmonary dysplasia, unless they have pulmonary hypertension, are maintained at oxygen saturation levels of 90–92% rather than 
95%. Supine sleeping is instituted in prematurely born infants without contraindications several weeks prior to neonatal discharge to reinforce to parents the importance of supine sleeping their baby at home. Further research is required to identify the optimal respiratory support strategy, particularly for very immature infants.
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This article has been cited by other articles:
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Bhandari, A., Bhandari, V.
(2009). Pitfalls, Problems, and Progress in Bronchopulmonary Dysplasia. Pediatrics
123: 1562-1573
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