Management of infants with bronchopulmonary dysplasia in Germany.

Although official guidelines for diagnosis and treatment of bronchopulmonary dysplasia (BPD) exist in Germany the practice in tertiary care neonatology centres differs considerably. There is no consensus about the appropriate level of oxygen saturation for infants at risk for BPD or infants with established BPD. Targeting oxygen saturation just below 90% in the first weeks and in the lower nineties thereafter seems to be a reasonable approach. Systemic corticosteroids must be used very restrictively because of adverse short- and long-term outcomes. Diuretics, inhaled corticosteroids, and bronchodilators may be used based on a stringent assessment of the individual response; their routine use cannot be recommended. Domiciliary oxygen is a therapy rarely prescribed in Germany although, if carefully planned and organised, it is safe and effective. Infants with home oxygen need a close follow-up by neonatologists and other specialists. Routine vaccination is recommended from the postnatal age of 3 months onwards.