Prognóstico pulmonar em prematuros

Abstract

Objective: The increased survival of preterm infants poses the challenge of dealing with a wide range of chronic pulmonary diseases, including bronchopulmonary dysplasia, Wilson-Mikity syndrome and recurrent wheezing. This article reviews the pulmonary clinical and functional prognosis of preterm newborns in infancy and adolescence.Source of data: MEDLINE search for articles published between 1970 and 2004 that focused on lung growth and function of preterm infants, besides a clinical follow-up of this group.Summary of the findings: Prenatal and postnatal events, such as placental insufficiency, tobacco exposure, infections, oxygen and mechanical ventilation, have an important effect on lung development and can lead to chronic lung diseases, of which bronchopulmonary dysplasia is the most severe complication. However, significant loss of lung function occurs in preterm infants who do not fulfill the criteria for bronchopulmonary dysplasia, and even in those who did not have significant respiratory disease during the neonatal period. The impact of prematurity on the respiratory system of these patients is usually underestimated. Clinically, preterm infants have an increased incidence of pneumonia and bronchiolitis, hospital readmissions due to respiratory diseases, chronic cough and wheezing and bronchial hyperresponsiveness. In adolescence, there is a tendency for normalization of the lung function, but they persist with reduced flows, lower exercise tolerance and bronchial hyperresponsiveness.Conclusions: Prematurity, the events that cause it and the interventions that follow it permanently change the development of the respiratory system. Studies are necessary to clarify the effect of each of these perinatal insults on the development of the respiratory system. J Pediatr (Rio J). 2005;81(1 Suppl):S79-S88: Premature infant, bronchopulmonary dysplasia, spirometry, breath tests, hyaline membrane disease.

Displasia Broncopulmonar: Definição, Fisiopatologia e Tratamento: Revisão da Literatura

“…95 ISSN 2317-2460 -doi: http://dx.doi.org/10.18616/is.v4i2.2238. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] articles were used from 2000 to 2016. Discussion: Bronchopulmonary dysplasia is a multifactorial disease.…”

“…A ventilação mecânica invasiva manejada de forma 'imperita' pode levar a atelectraumas, volutraumas e barotraumas. As consequências podem ser desastrosas para pulmões em desenvolvimento 9 .…”

“…Pacientes com displasia broncopulmonar podem apresentar alterações no tecido cardíaco, metaplasia no tecido pulmonar e cor pumonale. O aparecimento da displasia broncopulmonar é inversamente proporcional à idade gestacional e o peso ao nascer [7][8][9][11][12][13] . O objetivo foi apresentar uma revisão da literatura sobre a displasia broncopulmonar, sua fisiopatologia e suas formas de tratamento.…”

Suporte ventilatório ao nascer e associação com doenças respiratórias aos seis anos: Coorte de Nascimentos de Pelotas, Rio Grande do Sul, Brasil, 2004

“…Various studies have also found that premature newborns that received mechanical ventilation (MV) during the neonatal period showed greater risk of developing respiratory diseases like asthma and pneumonia in early childhood when compared to those that did not receive MV 13,14,15,16,17 . Neonatal MV was also associated with altered pulmonary function (spirometry) at 8-9 years 18 , as well as increased odds of asthma during childhood and adulthood 19,20,21 .…”

Impacto do tipo de parto sobre a mobilidade Toracoabdominal de recém-nascidos

“…To sustain life, at birth the lungs undergo a rapid transition from an organ filled with fluid unable to perform sufficient exchange for an air-filled organ that is capable of performing all gas exchange 1 . However, several mechanisms work together to reduce and eliminate the amount of pulmonary fluid.…”