The new bronchopulmonary dysplasia

Abstract

Purpose of Review BPD remains the most common severe complication of preterm birth. A number of recent animal models and clinical studies provide new information about pathophysiology and treatment. Recent Findings The epidemiology of BPD continues to demonstrate that birth weight or gestational age are most predictive of BPD. Correlations of BPD with chorioamnionitis are clouded by the complexity of the fetal exposures to inflammation. Excessive oxygen use in preterm infants can increase the risk of BPD, but low saturation targets may increase death. Numerous recent trials demonstrate that many preterm infants can be initially stabilized after delivery with CPAP and then be selectively treated with surfactant for RDS. The growth of the lungs of the infant with BPD through childhood remains poorly characterized. Summary Recent experiences in neonatology suggest that combining less invasive care strategies that avoid excessive oxygen and ventilation, decrease postnatal infections, and optimize nutrition may decrease the incidence and severity of BPD.

Therapeutic interventions and short-term outcomes for infants with severe bronchopulmonary dysplasia born at <32 weeks’ gestation

“…Infants in this cohort were frequently born of multiple gestation pregnancies, were small for GA and at least 1 in 10 were exposed to chorioamnionitis; these findings are consistent with existing work suggesting an association between BPD and an unfavorable intrauterine environment, 4,23 and even a different biological mechanism for developing sBPD. 24 In addition, these infants frequently had significant morbidities already existing at the time of referral to the regional NICU.…”

“…[2][3][4][5] These adverse outcomes highlight the need for further research to focus on both the co-morbid conditions that frequently accompany sBPD as well as potential therapies to improve the care and outcomes for affected infants. 5,6 With a validated definition and reported prevalence of 19% among extremely low birth weight infants, 1,7 prematurity-associated sBPD has proven challenging to study because single neonatal intensive care units (NICUs) have few patients who develop this condition.…”

Impacto Da Displasia Broncopulmonar Na Musculatura Respiratória Acessória De Lactentes.

“…Esta doença é, em potencial, uma desordem do desenvolvimento do sistema respiratório do recém-nascido pré-termo, na qual, o pulmão ainda imaturo, não atinge toda sua estrutura morfológica e funcional, que resulta na formação de grandes alvéolos [2] com superfície reduzida de trocas gasosas [3] e por consequência gera uma obstrução do fluxo aéreo pulmonar e uma sobrecarga dos músculos principais da respiração na tentativa de vencer a resistência das vias aéreas e adequar a ventilação pulmonar [4,5].…”

Prophylactic Administration of Surfactant with Nasal Continuous Positive Airway Pressure in Preterm Infants with Gestational Age Less than 30 Weeks

“…유발하여 미숙아에서 기관지폐 형성 이상의 발생을 증가 시킨다 [6][7][8][9] . The oxygenation rapidly improved following the surfactant treatment in the infants treated with both methods and sustained over 72 hours.…”