Chronic Lung Disease (Bronchopulmonary Dysplasia)

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					Chronic Lung Disease
(Bronchopulmonary Dysplasia)
The respiratory system in
babies
What is chronic lung disease (CLD)?

 It is a general term for long-term
respiratory problems in premature
babies. It is also known as
bronchopulmonary dysplasia
(BPD).
What causes chronic lung
disease?



    CLD results from lung injury to
newborns who must use a mechanical
ventilator and extra oxygen for
breathing.
Cont.
    Some of the causes of lung injury include 
the following :-
 prematurity - the lungs, especially the air sacs,
  are not fully developed
 low amounts of surfactant (a substance in the
  lungs that helps keep the tiny air sacs open)
 oxygen use (high concentrations of oxygen can
  damage the cells of the lungs)
 mechanical ventilation - the pressure of air from
  breathing machines, suctioning of the airways, use
  of an endotracheal tube.
Who is affected by chronic lung
disease?



     Chronic lung disease can develop
in premature babies who have had
mechanical ventilation (breathing
machine).
     Risk factors for developing CLD
include:

* birth at less than 34 weeks gestation
* birthweight less than 2,000 grams (4
  pounds 6.5 ounces)
* hyaline membrane disease - lung disease
  of prematurity due to lack of surfactant
  that does not show the usual
  improvement by the third or fourth day
* pulmonary interstitial emphysema (PIE) - a
  problem in which air leaks out of the
  airways into the spaces between the small
  air sacs of the lungs.
 * patent ductus arteriosus (PDA) - a
   connection between the blood vessels of
   the heart and lungs that does not close as it
   should after birth.
 * Caucasian, male babies
 * maternal womb infection
   (chorioamnionitis)
 * a family history of asthma
What are the symptoms of chronic
lung disease?
   The following are the most common
symptoms of CLD. However, each baby may
experience different symptoms of the condition.
Symptoms may include:
 respiratory distress (rapid breathing, flaring
of the nostrils, chest retractions)
 continued need for mechanical ventilation or
oxygen after a premature baby reaches 36
weeks gestation
How is chronic lung disease
diagnosed?
1.   when a premature baby with
     respiratory problems continues to need
     additional oxygen after reaching 36
     weeks gestational age.
2.    Chest x-rays
      show changes in the appearance of the
     lungs compared with previous x-rays
Treatment of chronic lung disease:

Specific treatment for CLD will be determined by
the physician based on:
 gestational age, overall health, and medical
history of the baby
 extent of the disease
 baby's tolerance for specific medications,
procedures, or therapies
 expectations for the course of the disease
Treatment of CLD may include:

    extra oxygen (to make up for the
decreased breathing ability of the damaged
lungs)
    mechanical ventilation with gradual
weaning as the baby's lungs grow and can
do more of the work of breathing
medications such as:
 * Bronchodilators (to help open the airways)
 * Steroids to help reduce inflammation)
   limiting fluids and giving a medication
(diuretic) to help reduce excess fluid which can
worsen breathing ability
   nutrition (to help the baby and the lungs grow)
immunization against lung infection by respiratory
syncytial virus (RSV) and influenza
      Finally CLD can be a long-term condition.
Some babies with CLD require mechanical
ventilators for several months.\

     Some babies will continue to require oxygen
when they go home from the hospital, but most can
be weaned from oxygen by the end of their first
year. Babies with CLD may be at increased risk for
respiratory infection and may have to be re-
hospitalized.

				
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posted:8/30/2012
language:English
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