Vogel Elizabeth R, Britt Rodney D, Trinidad Mari Charisse, Faksh Arij, Martin Richard J, MacFarlane Peter M, Pabelick Christina M, Prakash Y S
a Department of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Can J Physiol Pharmacol. 2015 Feb;93(2):119-27. doi: 10.1139/cjpp-2014-0387. Epub 2014 Dec 9.
Lung diseases, such as bronchopulmonary dysplasia (BPD), wheezing, and asthma, remain significant causes of morbidity and mortality in the pediatric population, particularly in the setting of premature birth. Pulmonary outcomes in these infants are highly influenced by perinatal exposures including prenatal inflammation, postnatal intensive care unit interventions, and environmental agents. Here, there is strong evidence that perinatal supplemental oxygen administration has significant effects on pulmonary development and health. This is of particular importance in the preterm lung, where premature exposure to room air represents a hyperoxic insult that may cause harm to a lung primed to develop in a hypoxic environment. Preterm infants are also subject to increased episodes of hypoxia, which may also result in pulmonary damage and disease. Here, we summarize the current understanding of the effects of oxygen on the developing lung and how low vs. high oxygen may predispose to pulmonary disease that may extend even into adulthood. Better understanding of the underlying mechanisms will help lead to improved care and outcomes in this vulnerable population.
肺部疾病，如支气管肺发育不良（BPD）、喘息和哮喘，仍然是儿科人群发病和死亡的重要原因，尤其是在早产情况下。这些婴儿的肺部结局受到围产期暴露的高度影响，包括产前炎症、产后重症监护病房干预和环境因素。在此，有强有力的证据表明围产期补充氧气对肺部发育和健康有显著影响。这在早产肺中尤为重要，因为过早暴露于室内空气代表着一种高氧损伤，可能会对准备在低氧环境中发育的肺造成损害。早产儿还更容易出现缺氧发作，这也可能导致肺部损伤和疾病。在此，我们总结了目前对氧气对发育中肺的影响的理解，以及低氧与高氧如何可能导致甚至延续至成年期的肺部疾病。更好地理解潜在机制将有助于改善这一脆弱人群的护理和结局。
