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Concept: Bronchopulmonary dysplasia

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Previous results from our trial of early treatment with continuous positive airway pressure (CPAP) versus early surfactant treatment in infants showed no significant difference in the outcome of death or bronchopulmonary dysplasia. A lower (vs. higher) target range of oxygen saturation was associated with a lower rate of severe retinopathy but higher mortality. We now report longer-term results from our prespecified hypotheses.

Concepts: Cardiology, Outcome, Pulse oximetry, Oxygen saturation, Oxygen sensor, Pulse oximeter, Bronchopulmonary dysplasia

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INTRODUCTION: The prevalence of bronchopulmonary dysplasia (BPD), one of the most frequently occurring complications following preterm birth, is increasing due to increased survival of preterm infants. METHODS: Systematic literature review. CONCLUSION: The etiology is multifactorial, with prematurity being a prerequisite for the development of BPD. Over time, there have been many different and new treatment modalities, some of them have reduced the severity of the disease, but none of them have been able to impact upon the increasing incidence of BPD.

Concepts: Childbirth, Epidemiology, Disease, Incidence, Prevalence, Preterm birth, Debut albums, Bronchopulmonary dysplasia

27

A 23-week-old baby, born at 26(+2) weeks, presented to the hospital with critical respiratory failure, which was impossible to stabilize. She had unstable oxygen saturations between 35% and 95%. A presumptive diagnosis of bronchopulmonary dysplasia with associated pulmonary hypertensive crisis was made. In the absence of inhaled nitric oxide, 2 oral doses of 1 mg/kg sildenafil were given, with a dramatic improvement 30 to 45 minutes later. Her oxygenation index fell from 43 to 14. She made a full recovery and was discharged from the hospital 2 weeks later.

Concepts: Pulmonology, Pneumonia, Cardiology, Nitrogen, Nitric oxide, Bronchopulmonary dysplasia

23

Bronchopulmonary dysplasia (BPD) and the associated complication of pulmonary hypertension (PH) leads to increased mortality and a longer length of stay among survivors. Placental histopathology may give early clues of subsequent events. The objective was to evaluate the relationship of maternal vascular underperfusion (MVU) changes on placental histopathology with subsequent development of BPD-associated PH in a cohort of extremely premature infants.

Concepts: Histopathology, Bronchopulmonary dysplasia

14

Respiratory distress syndrome (RDS) is a major cause of mortality and morbidity in premature infants. By the time symptoms appear it may already be too late to prevent a severe course, with bronchopulmonary dysplasia or mortality. We aimed to develop a rapid test of lung maturity for targeting surfactant supplementation.

Concepts: Pulmonology, Acute respiratory distress syndrome, Infant respiratory distress syndrome, Mucus, Bronchopulmonary dysplasia

6

Systemic glucocorticoids reduce the incidence of bronchopulmonary dysplasia among extremely preterm infants, but they may compromise brain development. The effects of inhaled glucocorticoids on outcomes in these infants are unclear.

Concepts: Glucocorticoid, Preterm birth, Bronchopulmonary dysplasia

4

To reduce the risk of bronchopulmonary dysplasia in extremely-low-birth-weight infants, clinicians attempt to minimize the use of endotracheal intubation by the early introduction of less invasive forms of positive airway pressure.

Concepts: Mechanical ventilation, Endotracheal tube, Intubation, Bronchopulmonary dysplasia

2

To determine the comparative efficacy and safety of corticosteroids in the prevention of bronchopulmonary dysplasia (BPD) in preterm infants.

Concepts: Preterm birth, Bronchopulmonary dysplasia

2

Placebo-controlled trials have shown that caffeine is highly effective in treating apnoea of prematurity and reduces the risk of bronchopulmonary dysplasia (BPD) and neurodevelopmental impairment (NDI).

Concepts: Bronchopulmonary dysplasia

2

Extremely preterm infants often receive mechanical ventilation (MV), which can contribute to bronchopulmonary dysplasia (BPD). However, the effects of MV alone on the extremely preterm lung and the lung’s capacity for repair are poorly understood.

Concepts: Pulmonology, Lung, Fetus, Pneumonia, Tuberculosis, Pneumothorax, Bronchopulmonary dysplasia