Nebulized Furosemide in the Treatment of Bronchopulmonary Dysplasia in Preterm Infants

2011 ◽  
Vol 16 (1) ◽  
pp. 14-22 ◽  
Author(s):  
Jasmine Sahni ◽  
Stephanie J. Phelps
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
The United States ◽  
Supplemental Oxygen ◽  
Assisted Mechanical Ventilation ◽  
Increased Risk ◽  
Single Intervention ◽  
Effective Use ◽  
Medical Advances

ABSTRACT Bronchopulmonary dysplasia (BPD) is a chronic pulmonary disease commonly seen in preterm infants who require supplemental oxygen and/or assisted mechanical ventilation. BPD, a major cause of morbidity and mortality among premature infants, occurs in 5,000 to 10,000 premature infants in the United States each year. Despite numerous medical advances, no single intervention will prevent or treat BPD; hence, premature infants have an increased risk for developing significant sequelae that affect both cognitive and motor function. This article provides a brief overview of BPD and reviews the available literature regarding the safe and effective use of nebulized furosemide in the treatment of this disorder.

scholarly journals Non-Invasive Ventilatory Strategies to Decrease Bronchopulmonary Dysplasia—Where Are We in 2021?

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 132
Author(s):  
Vikramaditya Dumpa ◽  
Vineet Bhandari
Keyword(s):  
Lung Injury ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Extremely Low Birth Weight ◽  
Positive Pressure ◽  
Invasive Ventilation ◽  
Clinical Practices ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Increased Risk

Recent advances in neonatology have led to the increased survival of extremely low-birth weight infants. However, the incidence of bronchopulmonary dysplasia (BPD) has not improved proportionally, partly due to increased survival of extremely premature infants born at the late-canalicular stage of lung development. Due to minimal surfactant production at this stage, these infants are at risk for severe respiratory distress syndrome, needing prolonged ventilation. While the etiology of BPD is multifactorial with antenatal, postnatal, and genetic factors playing a role, ventilator-induced lung injury is a major, potentially modifiable, risk factor implicated in its causation. Infants with BPD are at a higher risk of developing complications including sepsis, pulmonary arterial hypertension, respiratory failure, and death. Long-term problems include increased risk of hospital readmissions, respiratory infections, and asthma-like symptoms during infancy and childhood. Survivors who have BPD are also at increased risk of poor neurodevelopmental outcomes. While the ultimate solution for avoiding BPD lies in the prevention of preterm births, strategies to decrease its incidence are the need of the hour. It is time to focus on gentler modes of ventilation and the use of less invasive surfactant administration techniques to mitigate lung injury, thereby potentially decreasing the burden of BPD. In this article, we discuss the use of non-invasive ventilation in premature infants, with an emphasis on studies showing an effect on BPD with different modes of non-invasive ventilation. Practical considerations in the use of nasal intermittent positive pressure ventilation are also discussed, considering the significant heterogeneity in clinical practices and management strategies in its use.

Severity of Bronchopulmonary Dysplasia Among Very Preterm Infants in the United States

PEDIATRICS ◽  
2021 ◽  
pp. e2020030007
Author(s):  
Erik A. Jensen ◽  
Erika M. Edwards ◽  
Lucy T. Greenberg ◽  
Roger F. Soll ◽  
Danielle E.Y. Ehret ◽  
...  
Keyword(s):  
United States ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
The United States ◽  
Very Preterm Infants ◽  
Very Preterm

scholarly journals Hypertensive Disorders during Pregnancy and Risk of Bronchopulmonary Dysplasia in Very Preterm Infants

2018 ◽  
Vol 36 (02) ◽  
pp. 176-183
Author(s):  
Filipa de Lima ◽  
Ana Machado ◽  
Hercília Guimarães ◽  
Gustavo Rocha ◽  
Keyword(s):  
Arterial Hypertension ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Hypertension ◽  
Newborn Infants ◽  
Chronic Hypertension ◽  
Very Preterm Infants ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Preterm Babies

Introduction It is not yet fully known whether hypertensive disorders (HTD) during pregnancy impose an increased risk of development of bronchopulmonary dysplasia (BPD) in preterm newborn infants. Objective To test the hypothesis that preeclampsia and other HTD are associated with the development of BPD in preterm infants. Materials and Methods Data on mothers and preterm infants with gestational age 24 to 30 weeks were prospectively analyzed in 11 Portuguese level III centers. Statistical analysis was performed using IBM SPSS statistics 23. Results A total of 494 preterm infants from 410 mothers were enrolled, and 119 (28%) of the 425 babies, still alive at 36 weeks, developed BPD. The association between chronic arterial hypertension, chronic arterial hypertension with superimposed preeclampsia, and gestational hypertension in mothers and BPD in preterm infants was not significant (p = 0.115; p = 0.248; p = 0.060, respectively). The association between preeclampsia–eclampsia and BPD was significant (p = 0.007). The multivariate analysis revealed an association between preeclampsia–eclampsia and BPD (odds ratio [OR] = 4.6; 95% confidence interval [CI] 1.529–13.819; p = 0.007) and a protective effect for BPD when preeclampsia occurred superimposed on chronic arterial hypertension in mothers (OR = 0.077; 95%CI 0.009–0.632; p = 0.017). Conclusion The results of this study support the association of preeclampsia in mothers with BPD in preterm babies and suggest that chronic hypertension may be protective for preterm babies.

scholarly journals Respiratory Tract Microecology and Bronchopulmonary Dysplasia in Preterm Infants

2021 ◽  
Vol 9 ◽  
Author(s):  
Tong Sun ◽  
Haiyang Yu ◽  
Jianhua Fu
Keyword(s):  
Respiratory Tract ◽  
Microbial Diversity ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Respiratory Complication ◽  
Prevention And Treatment ◽  
New Ideas

Bronchopulmonary dysplasia (BPD) is a severe respiratory complication in preterm infants. Although the etiology and pathogenesis of BPD are complex and remain to be clarified, recent studies have reported a certain correlation between the microecological environment of the respiratory tract and BPD. Changes in respiratory tract microecology, such as abnormal microbial diversity and altered evolutional patterns, are observed prior to the development of BPD in premature infants. Therefore, research on the colonization and evolution of neonatal respiratory tract microecology and its relationship with BPD is expected to provide new ideas for its prevention and treatment. In this paper, we review microecological changes in the respiratory tract and the mechanisms by which they can lead to BPD in preterm infants.

scholarly journals Bibliometric analysis of bronchopulmonary dysplasia in extremely premature infants in the Web of Science database using CiteSpace software

2021 ◽  
Author(s):  
Qin Zhou ◽  
Haibo Kong ◽  
Baomei He ◽  
Suya Zhou
Keyword(s):  
United States ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Web Of Science ◽  
Perinatal Care ◽  
Ductus Arteriosus ◽  
The United States ◽  
High Yield ◽  
Management Of Complications ◽  
The Web

Abstract Objectives: To review the literature related to bronchopulmonary dysplasia in extremely premature infants, summarize research hotspots, and report trends. Methods: Relevant articles from 2008 to 2020 were retrieved from the Web of Science Core Collection database, and we extracted the following data: title, abstract, year, keywords, author, organization, journal and cited literature. We downloaded the data into CiteSpace (version 5.7.R3) to summarize countries, institutions, journals, and authors. We visualized the data with a knowledge map, collaborative network analysis, cluster analysis, and burst keyword analysis.Results: We identified 610 articles on bronchopulmonary dysplasia in extremely premature infants. The United States had the most articles on this topic (302 articles), followed by Canada (49 articles) and Germany (44 articles). The top three institutions, high-yield journals, and authors were all from the United States. The most common keywords were neurodevelopmental disorders, active perinatal care, mechanical ventilation, inflammation, pulmonary hypertension, low-dose hydrocortisone, development, and patent ductus arteriosus.Conclusions: This study illustrates the trends and frontiers in the study of bronchopulmonary dysplasia in extremely premature infants. The current hot issues are to identify the high-risk factors of bronchopulmonary dysplasia in extremely premature infants, reasonable hormone use, new cell therapy, and management of complications.

scholarly journals Sensory processing disorders in premature infants

Praxis medica ◽  
2021 ◽  
Vol 50 (1-2) ◽  
pp. 19-23
Author(s):  
Jelena Todorović ◽  
Mirjana Petrović-Lazić
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Sensory Processing ◽  
Relevant Literature ◽  
Sensory System ◽  
Neonatal Unit ◽  
Increased Risk ◽  
Sensory Processing Disorders ◽  
The Impact ◽  
Insight Into

Introduction. Children born prematurely have an increased risk of immediate medical complications, as well as socioemotional, cognitive, linguistic and sensory processing disorders later in life. Studies have examined the effects of prematurity on developmental outcomes, such as cognition, however, there is a need for a more detailed examination of sensory processing disorders in preterm infants. Not only is prenatal neurosensory development interrupted in utero, but these children may also experience intense stimulation in the neonatal unit, which can further alter the development and function of the sensory system. Objective. The paper presents an overview of research on sensory processing disorders in premature infants, with special emphasis on the impact of the environment of the neonatal unit. Method. Insight into the relevant literature was performed by specialized search engines on the Internet and insight into the electronic database. Results. Sensory processing disorders affect 39% to 52% of newborns born prematurely, with some evidence to suggest that children born before 32 weeks are most at risk. The literature to date has consistently reported difficulties in sensory modulation of preterm infants, within the tactile, vestibular, auditory, oral, and visual domains. Conclusion. Sensory processing disorders in preterm infants appear to occur as a result of their immature neurological and biological system and being in the environment of a neonatal intensive care unit, which is unable to meet the sensory needs of preterm infants. Altered sensory experiences, during periods of neurodevelopmental vulnerability and fragility, can result in sensory processing disorders, which may include enhanced responses or less response to stimuli (hyper or hyposensitivity).

Are Infants With Bronchopulmonary Dysplasia at Risk for Sudden Infant Death Syndrome?

PEDIATRICS ◽  
1994 ◽  
Vol 93 (5) ◽  
pp. 774-777
Author(s):  
Peter H. Gray ◽  
Yvonne Rogers
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Close Monitoring ◽  
Increased Risk

Objective. To compare the incidence of sudden infant death syndrome (SIDS) and apparent life-threatening event (ALTE) in infants with bronchopulmonary dysplasia (BPD) and birth weight-matched control infants in view of the changing pattern of chronic lung disease of prematurity. Methods. The study population consisted of 78 preterm infants of 26 to 33 weeks gestation who were diagnosed as having BPD and discharged. The 78 control infants were matched with the study infants for birth weight categories. Infants unable to maintain adequate oxygenation without supplemental oxygen when they were feeding well and thriving were discharged on home oxygen. All infants were at least 8 months of age at follow-up and information concerning the occurrence of any ALTE was obtained by direct parent interview. Results. No infant died during the period of follow-up. Seven (8.9%) of the study group compared with eight (10.5%) of the control infants had an ALTE. Three infants (one study, two control infants) were hospitalized for further investigation. No infant discharged on the home oxygen program had an ALTE. Conclusions. The data from this study suggest that preterm infants with BPD are not at increased risk from SIDS compared with preterm infants without this condition. This may be related to close monitoring of the infants' oxygenation status and the provision of home oxygen when appropriate, which should eliminate episodes of unrecognized and untreated hypoxemia. Home monitoring for infants with BPD may not be warranted.

Vitamin A and Bronchopulmonary Dysplasia: Research, Issues, and Clinical Practice

2004 ◽  
Vol 23 (4) ◽  
pp. 19-23 ◽  
Author(s):  
Anne Mentro
Keyword(s):  
Clinical Practice ◽  
Vitamin A ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Supplemental Oxygen ◽  
Clinical Implications ◽  
Plasma Vitamin ◽  
Term Infants ◽  
Vitamin A Supplementation ◽  
Research Issues

Vitamin A is a crucial antioxidant for preterm infants because it protects the lungs from oxidative damage induced by the administration of supplemental oxygen. Although all preterm infants are born with smaller vitamin A stores than full-term infants, the store of vitamin A in preterm infants at risk for bronchopulmonary dysplasia (BPD) is often especially deficient. Despite the increases in plasma vitamin A concentrations that have been achieved with vitamin A supplementation, only modest improvements in clinical outcomes and incidence of BPD have been noted in this population. This article reviews the research on vitamin A supplementation for preterm infants, as well as the issues and clinical implications associated with this intervention.

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