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支气管肺发育不良需行气管切开术:治疗与结局的综述。

Bronchopulmonary dysplasia requiring tracheostomy: A review of management and outcomes.

机构信息

Louisiana State University Health Sciences Center, School of Medicine, 533 Bolivar Street, New Orleans, LA, 70112, USA.

Pediatric Cardiology, Louisiana State University Health Sciences Center, Department of Pediatrics, 200 Henry Clay Avenue, New Orleans, LA, 70118, USA; Children's Hospital New Orleans, 200 Henry Clay Avenue, New Orleans, LA, 70118, USA.

出版信息

Int J Pediatr Otorhinolaryngol. 2020 Dec;139:110449. doi: 10.1016/j.ijporl.2020.110449. Epub 2020 Oct 22.

Abstract

Bronchopulmonary Dysplasia (BPD) is a pulmonary disease affecting newborns, commonly those with prematurity or low birth weight. Its pathogenesis involves underdevelopment of lung tissue with subsequent limitations in ventilation and oxygenation, resulting in impaired postnatal alveolarization. Despite advances in care with improved survival, BPD remains a prevalent comorbidity of prematurity. In severe cases, management may involve mechanical ventilation via tracheostomy. BPD's demand for multidisciplinary care compounds the challenges in management of this condition. Here, we review existing literature: the history of disease, criteria for diagnosis, pathogenesis, and modes of treatment with a focus on the severe subtype: that which is associated with pulmonary hypertension (PAH) for which tracheostomy is often required to facilitate long-term mechanical ventilation. We review the current recommendations for tracheostomy and decannulation.

摘要

支气管肺发育不良(BPD)是一种影响新生儿的肺部疾病,通常发生于早产儿或低出生体重儿。其发病机制涉及肺组织发育不良,随后通气和氧合受限,导致出生后肺泡化受损。尽管随着治疗的进步,存活率有所提高,但 BPD 仍然是早产儿的常见并发症。在严重的情况下,可能需要通过气管切开术进行机械通气治疗。BPD 需要多学科的护理,这增加了管理这种疾病的挑战。在这里,我们回顾了现有文献:疾病的历史、诊断标准、发病机制和治疗模式,重点关注严重的亚型:与肺动脉高压(PAH)相关的亚型,通常需要气管切开术来促进长期机械通气。我们还回顾了气管切开术和拔管的当前建议。

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