Sankar M Jeeva, Agarwal Ramesh, Deorari Ashok K, Paul Vinod K
Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Indian J Pediatr. 2008 Apr;75(4):369-76. doi: 10.1007/s12098-008-0041-6. Epub 2008 May 18.
Chronic lung disease (CLD) or bronchopulmonary dysplasia (BPD) occurs in preterm infants who require respiratory support in the first few days of birth. Apart from prematurity, oxygen therapy and assisted ventilation, factors like intrauterine/postnatal infections, patent ductus arteriosus, and genetic polymorphisms also contribute to its pathogenesis. The severe form of BPD with extensive inflammatory changes is rarely seen nowadays; instead, a milder form characterized by decreased alveolar septation due to arrest in lung development is more common. A multitude of strategies, mainly pharmacological and ventilatory, have been employed for prevention and treatment of BPD. Unfortunately, most of them have not been proved to be beneficial. A comprehensive protocol for management of BPD based on the current evidence is discussed here.
慢性肺部疾病(CLD)或支气管肺发育不良(BPD)发生于出生后最初几天需要呼吸支持的早产儿。除早产、氧疗和辅助通气外,宫内/产后感染、动脉导管未闭和基因多态性等因素也参与其发病机制。如今,伴有广泛炎症改变的严重形式的BPD已很少见;相反,以肺发育停滞导致肺泡间隔减少为特征的较轻形式更为常见。预防和治疗BPD已采用了多种策略,主要是药物和通气策略。不幸的是,其中大多数尚未被证明有益。本文讨论了基于当前证据的BPD综合管理方案。