Bronchopulmonary dysplasia: a new look at management
Article Abstract:
A series of articles concerning bronchopulmonary dysplasia is presented in the October 1990 issue of Archives of Diseases of Childhood, Fetal and Neonatal edition. This condition of newborn, and, especially, premature infants is a common complication when babies are treated in neonatal intensive care units. Important aspects of managing patients with bronchopulmonary dysplasia in the hospital and at home are discussed. In the hospital, these include the differential diagnosis of the disease; prevention of hypoxemia (low levels of oxygen in the blood); the dangers of increased retention of carbon dioxide and of anemia (reduced level of red blood cells); the value of ventilation with negative pressure (less than atmospheric pressure); the role of treatment with diuretics (which increase excretion of salt and water) and corticosteroids; the importance of proper nutrition and preventing infection; and methods of monitoring infants under treatment. Discharge home should be preceded by a meeting of all personnel who have been significantly involved in the case. Since preterm infants are at risk for sudden death, and infants with bronchopulmonary dysplasia are perhaps at even greater risk, monitoring is essential. Oxygen needs to be available at home and as a mobile supply. The infant is particularly vulnerable to respiratory infections, and anyone who is sick should not visit. Immunizations should be completed, especially for pertussis (whooping cough), and good nutrition should be maintained. Infants with bronchopulmonary dysplasia need extra exercises and stimulation, and both they and their families benefit from emotional support. Parents should know how to administer cardiac massage and ventilation with a bag and mask. Much can be done for infants with this disorder. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Disease in Childhood
Subject: Health
ISSN: 0003-9888
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
Recurrent cyanotic episodes with severe arterial hypoxaemia and intrapulmonary shunting: a mechanism for sudden death
Article Abstract:
Cyanotic episodes are attacks of severe hypoxemia (decreased blood oxygen level) that are not due to blockage of the airways or seizures. The low blood oxygen levels may be due to rapid use of oxygen or atelectasis, collapsed areas of the lung. Severe hypoxemia may develop rapidly despite ventilation, the provision of oxygen. The disease process of recurrent cyanotic episodes was assessed in 51 infants and children. Most patients experienced initial attacks at seven weeks of age. Episodes began suddenly and were associated with loss of consciousness due to decreased oxygen levels in the circulation of the brain. The attacks were apparently triggered by pain, anger, or fear. The occurrence of cyanotic episodes was reduced by tetrabenazine in 15 cases and additional oxygen in 10 cases. Eight patients died, including four who died during cyanotic episodes. Physiological tests were performed in 28 patients and showed no relation of cyanotic episodes to seizures or airway blockage. However, examination of the heart and lungs with diagnostic tests showed evidence of an intrapulmonary right to left shunt, or abnormal flow of blood within the lungs. Cyanotic episodes were also associated with prolonged absence of breathing during expiration. The possible mechanisms involved in the development of cyanotic episodes are described. Cyanotic episodes may cause sudden unexpected death in infancy and early childhood. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Disease in Childhood
Subject: Health
ISSN: 0003-9888
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
Hypoxaemia after nebulised salbutamol in wheezy infants: the importance of aerosol acidity
Article Abstract:
The blood performs the vital function of carrying oxygen to the tissues and organs in the body. When the amount of oxygen in the blood decreases (a condition known as hypoxemia), less oxygen is delivered to the tissues and their ability to function is affected. It has been observed that a drug called salbutamol can cause hypoxemia. This drug causes the air passages in the lungs to dilate or open and it is being used in clinical drug trails as a treatment for asthma. However, when this drug is administered to infants in an aerosol mist it can lower the amount of oxygen in the blood. To investigate this further, 34 infants with symptoms of wheeze were treated with salbutamol or placebo. When the salbutamol was inhaled in the form of an aerosol mist it caused the amount of oxygen in the blood to decrease. It was noticed that when salbutamol is converted into an aerosol it is acidic (pH 3.9). To determine if the acidity of the aerosol mist is responsible for the decrease in oxygen in the blood, a saline (salt) solution was prepared with the same amount of acid as the salbutamol. When the infants inhaled the acidic saline mist the amount of oxygen in the blood decreased. These findings indicate that the acidity of the aerosol may cause the amount of oxygen in the blood to decrease and that aerosols that are acidic should be neutralized (made less acidic) before they are used to treat infants with asthma. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Disease in Childhood
Subject: Health
ISSN: 0003-9888
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: Antimicrobial resistance of Shigella isolates in the USA: the importance of international travelers. Chronic diarrhea associated with drinking untreated water
- Abstracts: A phase I trial of CGS 16949A: a new aromatase inhibitor. Thyroid dysfunction in elderly hospitalized patients: effect of age and severity of illness
- Abstracts: Prophylactic amnioinfusion as a treatment for oligohydramnios in laboring patients: a prospective, randomized trial
- Abstracts: Neonatal complications at term as related to the degree of umbilical artery acidemia. The relationship between maternal serum and amniotic fluid alpha-fetoprotein in women undergoing early amniocentesis
- Abstracts: Management of radionecrosis of the vulva and distal vagina. The effects of cold therapy on postoperative pain in gynecologic patients: a prospective, randomized study