Bronchopulmonary dysplasia is a chronic lung disease caused by the use of mechanical ventilation of lungs and high oxygen concentrations in premature infants with SDR.
Pathogenesis of Bronchopulmonary Dysplasia
As a rule, bronchopulmonary dysplasia develops in deeply premature newborns (with a body weight of less than 1000 g). Damage to the lungs can result from a deficit in the surfactant (the collapse of the alveoli with uneven ventilation causes a direct damaging effect on the pulmonary tissue), pulmonary edema, prolonged use of high oxygen concentrations (impairment of ciliary mobility, oxygen damage to free radicals, etc.), mechanical damage pressure, inadequately heated and humidified air, etc.), inflammation, etc. As a result of the above factors, virtually all structural components of the immature l of pulmonary tissue, which leads to chronic disturbance in lung function.
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Bronchopulmonary Dysplasia[/caption]Clinical picture of Bronchopulmonary Dysplasia
Bronchopulmonary dysplasia usually occurs in a premature infant with SDR, which is on a ventilator for more than 5-6 days. If you try to stop the ventilation, respiratory failure occurs. The thorax of the child acquires a barrel shape, the retention of intercostal spaces persists, sometimes there is a stridor, signs of pulmonary hypertension and right ventricular failure. Subsequently, due to massive interstitial fibrosis, atelectasis and cystic emphysema, a chronic impairment of respiratory function is formed. X-ray data are diverse: tight interstitial pattern, dense foci (areas of sclerosis), alternating with areas of increased transparency ("honeycomb"), atelectasis, cysts.
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Treatment of Bronchopulmonary Dysplasia
Treatment of bronchopulmonary dysplasia is aimed at maintaining adequate oxygenation. If the child's condition improves, it should be switched to the supply of heated oxygen with the help of the nasal cannula for several weeks or months. An important role is also played by improving the methods of nursing deeply premature newborns, aimed at optimizing feeding (with increased calories) and temperature conditions.
From drugs, a long-term (up to 2-2.5 months) use of diuretics, hormonal drugs (dexamethasone), antibiotics, bronchodilators [salbutamol, aminophylline (euphyllin), ipratropium bromide, terbutaline], cardiac glycosides, vitamins A and E.
Forecast of Bronchopulmonary Dysplasia
Despite the reduction in the severity of bronchopulmonary dysplasia in recent years, lethality remains high - up to 30%. For several years, reduced lung elongation, an increased risk of bronchospasm and repeated respiratory diseases remain. With a favorable course, the normalization of the functional parameters of the lungs occurs only to 7-10 years.
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