Document Type

Article

Publication Date

8-2026

Identifier

DOI: 10.1038/s41372-025-02506-8; PMCID: PMC13472857

Abstract

Bronchopulmonary dysplasia (BPD) is a leading cause of chronic respiratory failure in infants. Severe BPD is associated with prolonged mechanical ventilation, pulmonary hypertension, and high morbidity and mortality. As disease severity increases, extracorporeal membrane oxygenation (ECMO) is being reconsidered as a potential rescue therapy. Historically, ECMO has been reserved for neonates with reversible respiratory failure and those who required mechanical ventilation for less than 14 days, while infants with BPD were excluded. However, advancements in ECMO technology, anticoagulation strategies, and ventilatory management have led to a reassessment of its role in this population. Emerging reports suggest ECMO may serve as a bridge to recovery or lung transplantation for select infants with severe BPD and refractory respiratory failure. Careful patient selection remains critical, considering factors such as pulmonary hypertension severity, right ventricular dysfunction, and potential for lung recovery.

Journal Title

Journal of perinatology : official journal of the California Perinatal Association

Volume

46

Issue

8

First Page

1387

Last Page

1395

MeSH Keywords

Humans; Bronchopulmonary Dysplasia; Extracorporeal Membrane Oxygenation; Infant, Newborn; Respiratory Insufficiency; Respiration, Artificial; Hypertension, Pulmonary; Lung Transplantation; Patient Selection

PubMed ID

41792423

Keywords

Bronchopulmonary Dysplasia; Extracorporeal Membrane Oxygenation; Respiratory Insufficiency; Artificial Respiration; Pulmonary Hypertension; Lung Transplantation; Patient Selection

Comments

This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

Publisher's Link: https://www.nature.com/articles/s41372-025-02506-8

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