Context: One of the most important chronic clinical conditions seen in preterm babies is Bronchopulmonary Dysplasia (BPD) With improvement in technology and available therapeutic options, the survival rates have dramatically improved over time, how ever, the incidence of BPD still continues to remain the same even today. The injury resulting in BPD likely begins as altered lung development before delivery in many infants and can be initiated by resuscitation at birth and then amplified by postnatal exposures. The multifactorial pathogenesis implicated in the development of BPD necessitates a multidimensional therapeutic approach, to manage all the complex manifestations of the disorder.

Aims: The presently used approaches for prevention as well as management are being used for more than a decade, and lack definite evidence. The aim of this literature review is to gather evidence on the presently available prevention and management approaches for bronchopulmoanry dysplasia, as well as newer, promising therapeutic agents being experimented, in order to provide data to help optimize strategies in the NICU as well as OPD settings and help reduce the incidence of BPD and promote more definitive studies.

Methods and Materials: We carried out an extensive series of searches on PubMed database and tried to capture as many citations as possible for Bronchopulmonary dysplasia in pretermneonates, with peer-reviewed publications from 2000-2022. Approximately 96 studies, including animal studies, RCTs and systematic review and meta-analyses were considered. On going experiments were queried from Clinical Trials.gov. The searches were carried out using the terms: “Bronchopulmonary dysplasia”, “BPD”, “Preterm neonates”, “low birth weight”, “pathogenesis”, “diagnosis”,”prevention”,”treatment”. Further manual assessment was also done to include other relevant publications.

Results: Prevention of prematurity, systematic use of non-aggressive ventilator measures, avoiding supraphysiologic oxygen exposure and administration of surfactant, caffeine and vitamin A, antenatal glucorticosteroids, and pharmacotherapeutics agents like diuretics, vasodilators, nitric oxide etc. can significantly reduce the risk of BPD development. MSC therapy, IGF-1 and clara cell protein administration are the most fascinating new measure to address the lung damage due to BPD.

Conclusion: Despite advancement in technology and availability of a myriad of treatment options, the multifactorial nature of BPD makes it a persistently challenging disorder to treat and even more so to prevent. While multiple therapies are used routinely either alone or in combination (potentially increasing drug–drug interactions and associated side effects), there is insufficient evidence supporting short and longer-term use of many of these agents. There is continued need for future meta-analyses and prospective randomized controlled studies designed to measure clinically meaningful outcomes, and an even greater need to design trials evaluating the safety, efficacy, and dosing of pharmacologic agents in this population. Stem cell treatment and other such innovative strategies may be the beginning of a new era in the treatment of BPD. New ways of preventing or modulating BPD are on the horizon, and will hopefully lead to continued improvement of long-term outcome of prematurely born infants.