Bronchopulmonary dysplasia (BPD) is a chronic lung disease of multifactorial etiology characterized by the formation of respiratory failure and regressing as the child grows. With a severe form of BPD, adequate and safe respiratory support is required for a long time. The mechanical properties of the lungs in these patients differ significantly from those in acute respiratory pathology, which should be taken into account when setting the parameters of the ventilator. Important task is to determine the optimal moment for the transition to a strategy of respiratory support for damaged lungs, which is characterized by slow dynamics and specific parameter settings. In the absence of recommendations based on high quality evidence, most specialists choose a personalized approach that takes into account the specificity of respiratory mechanics in patients with severe BPD. An important goal is to achieve respiratory comfort, which allows achieving optimal growth and recovery of respiratory system. © 2024, Pediatria Ltd.. All rights reserved.