Abstract Ref Number = APCP113
Current Management of Chronic Lung Disease in Preterm Infants
Dr CiptoMangunkusumo National General Hospital CMNGH, Jakarta
Child and Adolescent Health Dept
Chronic lung disease/bronchopulmonary dysplasia (BPD) is a chronic lung diseaseseen most typically in preterm infants who received mechanical ventilation and oxygen therapy for acute respiratory distress.Mechanical lung over-distension and alveolar stretch play a critical role in the pathogenesis of BPD.BPD results in serious long-term morbidity despite the decline in mortality rates among very low birth weight (VLBW) neonates, such as recurrent pneumonia, growth retardation, decreased lung function and poorer neurodevelopmental outcome.
The incidence varies between newborn care centers. It is reported to be up to 77% in extremely low birth weight (ELBW) infants born at <32 weeks of gestation, reflecting differences in patient population and infant management practices. Significant improvements in perinatal care like surfactant treatment, administration of antenatal corticosteroids, and improvement of invasive and non-invasive ventilation strategies do not significantly alter the incidence of long-term sequelae associated with the disease in the most immature infants.
Current therapeutic measures help to modestly improve BPD. Caffeine, diuretics, postnatal corticosteroid, bronchodilators, pulmonary vasodilators, and anti-oxidant are the currently available pharmacological options to treat BPD.In mechanical ventilation, the volume targeted ventilation compared with pressure-limited ventilation is associated with a reduced risk of pneumothorax, hypocarbia, ventilation duration and severe intraventricular hemorrhage.Since BPD currently has no specific preventive or effective therapy, the use of non-invasive ventilation (NIV) is considered a means to potentially decrease the incidence of BPD.Protective ventilation strategies, targeted oxygen saturation goals, and optimization of nutrition, continue to be supportive.
Keywords: chronic lung disease,
bronchopulmonary dysplasia, management