Bronchopulmonary Dysplasia: An Update, An Issue of Clinics in Perinatology

Suhas G. Kallapur

Description

Bronchopulmonary dysplasia (BPD) as a chronic lung disease affecting preterm infants has been recognized for more than 45 years. However, little progress has been made in the prevention and treatment of the disease. BPD continues to be a major morbidity affecting preterm infants. Studies in pre-adolescent children demonstrate that the abnormal lung function from BPD persists well into childhood. Infants with BPD also have an increased risk for adverse neurodevelopmental outcome. Thus BPD imposes a significant burden of adverse health outcomes in preterm infants.

The major risk factors for BPD are prematurity, mechanical ventilation, exposure to noxious insults such as oxygen, infections. New research data both in basic science and clinical studies have shed light on the pathogenesis, and possible new treatment or management strategies for the future. In the proposed issue of the Clinics in Perinatology, we would like to comprehensively cover BPD both from a basic science and clinical perspective. Our attempt is to balance new information along with classic topics. The proposed authors for the issue are recognized experts in the topic area/s. We hope that the issue will be of interest to a broad array of readership.

Sujets

• Médecine
• Spécialités médicales
• Gynécologie et Obstétrique
• Perinatology
• Medical
• Neonatology

Informations

• Publié par: Elsevier
• Date de parution: 07 janvier 2016
• Nombre de lectures: 1
• EAN13: 9780323395786
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Bronchopulmonary Dysplasia: An Update
Clinics In Perinatology
Editors
Suhas G. Kallapur, MD
Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
Gloria S. Pryhuber, MD
Pediatrics and Environmental Medicine, Division of Neonatology, University of Rochester Medical Center, Rochester, New York, USA
Consulting Editor
Lucky Jain

Clinics Review Articles

www.Perinatology.theclinics.com

December 2015 Volume 42 Number 4
Table of Contents
Cover image
Title page
Copyright
Contributors
Consulting Editor
Editors
Authors
CME Accreditation Page
Forthcoming Issues
Forthcoming Issues
Recent Issues
Foreword. Why the Bronchopulmonary Dysplasia Improvement Curve Lags Behind
References
Preface. Bronchopulmonary Dysplasia-The Search for Answers Continues
Update on Molecular Biology of Lung Development-Transcriptomics
Key points
INTRODUCTION
Discussion
References
Postnatal Infections and Immunology Affecting Chronic Lung Disease of Prematurity
Key points
Introduction
Inflammation as a mechanism for respiratory morbidity
Prenatal induction of inflammation and respiratory morbidity
Postnatal induction of inflammation and respiratory morbidity
Susceptibility factors for enhanced inflammation
References
Role of Ureaplasma Respiratory Tract Colonization in Bronchopulmonary Dysplasia Pathogenesis: Current Concepts and Update
Key points
Introduction
Ureaplasma species
Epidemiologic evidence for role of Ureaplasma species in bronchopulmonary dysplasia pathogenesis
Diagnostic methods
Therapeutic considerations
Best practices: current recommendations and the future
References
Biomarkers, Early Diagnosis, and Clinical Predictors of Bronchopulmonary Dysplasia
Key points
Introduction
Why do we need biomarkers or predictors?
Biomarkers
The future of bronchopulmonary dysplasia diagnostics and biomarkers
References
Evidence-Based Pharmacologic Therapies for Prevention of Bronchopulmonary Dysplasia: Application of the Grading of Recommendations Assessment, Development, and Evaluation Methodology
Key points
Introduction
Methods
Summary of the evidence for individual therapies
Clinical trials registry search results
Summary
References
Mechanical Ventilation and Bronchopulmonary Dysplasia
Key points
Introduction
What is ventilator-associated lung injury?
Mitigating ventilator-associated lung injury
Importance of the golden first hour
Positive end-expiratory pressure in the delivery room
Sustained inflation
Hyperoxic injury
Noninvasive respiratory support
Less invasive surfactant administration
Lung-protective strategies of mechanical ventilation
Putting it all together
Summary
References
Impact of Nutrition on Bronchopulmonary Dysplasia
Key points
Introduction
Intrauterine growth and pulmonary outcomes
Postnatal growth and clinical outcomes
Growth outcomes of infants with bronchopulmonary dysplasia
Cause of poor growth in infants with bronchopulmonary dysplasia
Nutritional interventions to prevent bronchopulmonary dysplasia
Impact of treatment for bronchopulmonary dysplasia on nutritional status
Nutritional strategies to optimize growth
Postdischarge management of infants with bronchopulmonary dysplasia
Research opportunities in the role of nutrition and lung disease
References
Oxygen Saturation Targeting and Bronchopulmonary Dysplasia
Key points
Introduction
Oxygen monitoring
Oxygen toxicity
History of oxygen monitoring in preterm infants
Trials of oxygen saturation targeting and bronchopulmonary dysplasia
The Neonatal Oxygenation Prospective Meta-analysis trials of oxygen saturation targeting
The Neonatal Oxygenation Prospective Meta-analysis trials and bronchopulmonary dysplasia
What can be concluded from the evidence published to date?
Other issues that arise
References
Hypoxic Episodes in Bronchopulmonary Dysplasia
Key points
Introduction
Role of immature respiratory control in bronchopulmonary dysplasia
Consequences of intermittent hypoxic episodes
Role of the immature airway
Role of pulmonary vasoconstriction
Summary
References
Pulmonary Hypertension and Vascular Abnormalities in Bronchopulmonary Dysplasia
Key points
Introduction
Pathogenesis of pulmonary vascular disease in bronchopulmonary dysplasia
Diagnosis and epidemiology of pulmonary vascular disease in preterm infants
Risk factors for peripheral vascular disease and pulmonary hypertension in preterm infants
Other pulmonary vascular and cardiac abnormalities associated with bronchopulmonary dysplasia
Treatment of pulmonary hypertension in bronchopulmonary dysplasia
Summary
References
Airway Disease and Management in Bronchopulmonary Dysplasia
Key points
Introduction
Respiratory support of children with bronchopulmonary dysplasia
Weaning from nasal continuous positive airway pressure
Heated humidified high-flow nasal cannula therapy in children
Positive Pressure ventilation for treatment of apnea of prematurity
Outcomes of children with severe bronchopulmonary dysplasia who are ventilator dependent at home
Airway management of children with bronchopulmonary dysplasia
Subglottic stenosis
Tracheomalacia and tracheobronchomalacia
Indications for tracheotomy placement
Tracheotomy techniques and guidelines in neonates
Tracheotomy in the setting of chronic ventilator dependency
Timing of tracheotomy and outcomes in preterm infants
References
Newer Imaging Techniques for Bronchopulmonary Dysplasia
Key points
Introduction
Chest radiograph
Computerized tomography
Nuclear medicine
MRI
Summary
References
Bronchopulmonary Dysplasia and Chronic Lung Disease: Stem Cell Therapy
Key points
Introduction
Mesenchymal stromal cells
Disruption of mesenchymal stromal cell homeostasis in the events that lead to bronchopulmonary dysplasia
Preclinical evidence of mesenchymal stromal cell effects on arrested lung development
Preclinical evidence of mesenchymal stromal cell effects on disrupted vascular development
Preclinical evidence of mesenchymal stromal cell effects on inflammation, oxidative stress, and fibrosis
Long-term considerations from preclinical studies
Conclusions from preclinical data
Mechanism of action of mesenchymal stromal cells
Clinical translation
Efficacy of mesenchymal stromal cell treatment
Safety of mesenchymal stromal cell treatment
Summary
References
The Natural History of Bronchopulmonary Dysplasia: The Case for Primary Prevention
Key points
Introduction
Natural history of pulmonary function testing measurements
Natural history of respiratory symptoms in patients with bronchopulmonary dysplasia: clinical pulmonary outcomes
Evolution of radiographic/high-resolution computed tomography changes
Evolution of exercise tolerance through adulthood
Need for primary prevention of bronchopulmonary dysplasia
Future goals and research priorities for bronchopulmonary dysplasia prevention
References
Index
Copyright
ELSEVIER
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CLINICS IN PERINATOLOGY Volume 42, Number 4
December 2015 ISSN 0095-5108, ISBN-13: 978-0-323-39577-9
Editor: Kerry Holland
Developmental Editor: Casey Jackson
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