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Management bronchopulmonary dysplasia

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https://www.readbyqxmd.com/read/28503300/how-to-decrease-bronchopulmonary-dysplasia-in-your-neonatal-intensive-care-unit-today-and-tomorrow
#1
REVIEW
Leif D Nelin, Vineet Bhandari
Bronchopulmonary dysplasia, or BPD, is the most common chronic lung disease in infants. Genetic predisposition and developmental vulnerability secondary to antenatal and postnatal infections, compounded with exposure to hyperoxia and invasive mechanical ventilation to an immature lung, result in persistent inflammation, culminating in the characteristic pulmonary phenotype of BPD of impaired alveolarization and dysregulated vascularization. In this article, we highlight specific areas in current management, and speculate on therapeutic strategies that are on the horizon, that we believe will make an impact in decreasing the incidence of BPD in your neonatal intensive care units...
2017: F1000Research
https://www.readbyqxmd.com/read/28396025/prophylactic-indomethacin-compared-with-delayed-conservative-management-of-the-patent-ductus-arteriosus-in-extremely-preterm-infants-effects-on-neonatal-outcomes
#2
Melissa Liebowitz, Ronald I Clyman
OBJECTIVE: To determine whether prophylactic indomethacin (PINDO) has more or less morbidity than delayed conservative management of the moderate-to-large patent ductus arteriosus (PDA). STUDY DESIGN: We performed a prospective double cohort controlled study of infants delivered at ≤27(6/7) weeks gestation (n = 397). From January 2005 through April 2011, all infants were treated with PINDO (n = 247). From May 2011 through August 2016, no infant was treated with indomethacin until at least 8 postnatal days (conservative epoch, n = 150)...
April 7, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28338487/the-evolution-of-disease-chronic-lung-disease-of-infancy-and-pulmonary-hypertension
#3
Michael C Tracy, David N Cornfield
PURPOSE OF REVIEW: Bronchopulmonary dysplasia (BPD) or chronic lung disease of infancy BPD was originally described 50 years ago, in 1967 by Northway et al. This article possesses two fundamental objectives to provide: a brief historical perspective on BPD; and an update relative to current notions of epidemiology, pathophysiology, evaluation, and clinical management of BPD complicated by vascular disease. The review highlights areas of consensus and ongoing uncertainty. RECENT FINDINGS: The clinical cause and presentation of infants with BPD has evolved over the past several decades...
June 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28303154/mesenchymal-stem-cell-administration-in-patients-with-chronic-obstructive-pulmonary-disease-state-of-the-science
#4
REVIEW
Shih-Lung Cheng, Ching-Hsiung Lin, Chao-Ling Yao
Patients with chronic obstructive pulmonary disease (COPD) have chronic, irreversible airway inflammation; currently, there is no effective or curative treatment and the main goals of COPD management are to mitigate symptoms and improve patients' quality of life. Stem cell based therapy offers a promising therapeutic approach that has shown potential in diverse degenerative lung diseases. Preclinical studies have demonstrated encouraging outcomes of mesenchymal stem/stromal cells (MSCs) therapy for lung disorders including emphysema, bronchopulmonary dysplasia, fibrosis, and acute respiratory distress syndrome...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28267444/a-multicenter-prospective-study-of-neonatal-outcomes-at-less-than-32-weeks-associated-with-indications-for-maternal%C3%A2-admission-and-delivery
#5
Thomas J Garite, C Andrew Combs, Kimberly Maurel, Anita Das, Kevin Huls, Richard Porreco, Dale Reisner, George Lu, Melissa Bush, Bruce Morris, April Bleich
BACKGROUND: Counseling for patients with impending premature delivery traditionally has been based primarily on the projected gestational age at delivery. There are limited data regarding how the indications for the preterm birth affect the neonatal outcome and whether this issue should be taken into account in decisions regarding management and patient counseling. OBJECTIVE: We performed a prospective study of pregnancies resulting in premature delivery at less than 32 weeks to determine the influence of both the indications for admission and their associated indications for delivery on neonatal mortality and complications of prematurity...
March 3, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28214832/the-burden-of-respiratory-disease-in-very-low-birth-weight-infants-changes-in-perinatal-care-and-outcomes-in-a-decade-in-spain
#6
Fermín García-Muñoz Rodrigo, Antonio Losada Martínez, María Dolores Elorza Fernández, Julio Moreno Hernando, Josep Figueras Aloy, Máximo Vento Torres
BACKGROUND: Advances in perinatal care have led to a significant reduction in morbidity and mortality among very-low-birth-weight (VLBW) infants. Much of this progress is related to the prevention and management of respiratory disease. OBJECTIVES: To evaluate changes in perinatal care and its influence on respiratory morbidity and mortality among VLBW infants in Spain in 2 consecutive periods (2002-2006 and 2007-2011). METHODS: This is a retrospective analysis of data prospectively collected of all VLBW infants included in the Spanish SEN1500 network...
February 18, 2017: Neonatology
https://www.readbyqxmd.com/read/28176308/fluid-restriction-for-treatment-of-preterm-infants-with-chronic-lung-disease
#7
REVIEW
Keith J Barrington, Etienne Fortin-Pellerin, Thomas Pennaforte
BACKGROUND: Fluid restriction is often recommended as part of the management of infants with early or established bronchopulmonary dysplasia (BPD). OBJECTIVES: To determine whether fluid restriction as part of the therapeutic intervention for early or established BPD improves clinical outcomes. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1) in the Cochrane Library (searched 16 February 2016), MEDLINE via PubMed (1966 to 16 February 2016), Embase (1980 to 16 February 2016), and CINAHL (1982 to 16 February 2016)...
February 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28141913/systemic-corticosteroid-regimens-for-prevention-of-bronchopulmonary-dysplasia-in-preterm-infants
#8
REVIEW
Wes Onland, Anne Pmc De Jaegere, Martin Offringa, Anton van Kaam
BACKGROUND: Cochrane systematic reviews show that systemic postnatal corticosteroids reduce the risk of bronchopulmonary dysplasia (BPD) in preterm infants. However, corticosteroids have also been associated with an increased risk of neurodevelopmental impairment. It is unknown whether these beneficial and adverse effects are modulated by differences in corticosteroid treatment regimens. OBJECTIVES: To assess the effects of different corticosteroid treatment regimens on mortality, pulmonary morbidity, and neurodevelopmental outcome in very low birth weight (VLBW) infants...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28141790/caffeine-administration-modulates-tgf-%C3%AE-signaling-but-does-not-attenuate-blunted-alveolarization-in-a-hyperoxia-based-mouse-model-of-bronchopulmonary-dysplasia
#9
Philipp Rath, Claudio Nardiello, David E Surate Solaligue, Ronald Agius, Ivana Mižíková, Sebastian Hühn, Konstantin Mayer, István Vadász, Susanne Herold, Frank Runkel, Werner Seeger, Rory E Morty
BACKGROUND: Caffeine is widely used to manage apnea of prematurity, and reduces the incidence of bronchopulmonary dysplasia (BPD). Deregulated transforming growth factor (TGF)-β signaling underlies arrested postnatal lung maturation in BPD. It is unclear whether caffeine impacts TGF-β signaling or postnatal lung development in affected lungs. METHODS: The impact of caffeine on TGF-β signaling in primary mouse lung fibroblasts and alveolar epithelial type II cells was assessed in vitro...
May 2017: Pediatric Research
https://www.readbyqxmd.com/read/28129336/airway-microbial-community-turnover-differs-by-bpd-severity-in-ventilated-preterm-infants
#10
Brandie D Wagner, Marci K Sontag, J Kirk Harris, Joshua I Miller, Lindsey Morrow, Charles E Robertson, Mark Stephens, Brenda B Poindexter, Steven H Abman, Peter M Mourani
Preterm birth exposes the developing lung to an environment with direct exposure to bacteria, often facilitated by endotracheal intubation. Despite evidence linking bacterial infections to the pathogenesis of bronchopulmonary dysplasia (BPD), systematic studies of airway microbiota are limited. The objective was to identify specific patterns of the early respiratory tract microbiome from tracheal aspirates of mechanically ventilated preterm infants that are associated with the development and severity of BPD...
2017: PloS One
https://www.readbyqxmd.com/read/28114369/evidence-based-neonatal-unit-practices-and-determinants-of-postnatal-corticosteroid-use-in-preterm-births-below-30-weeks-ga-in-europe-a-population-based-cohort-study
#11
Alexandra Nuytten, Hélène Behal, Alain Duhamel, Pierre-Henri Jarreau, Jan Mazela, David Milligan, Ludwig Gortner, Aurélie Piedvache, Jennifer Zeitlin, Patrick Truffert
BACKGROUND: Postnatal corticosteroids (PNC) were widely used to treat and prevent bronchopulmonary dysplasia in preterm infants until studies showed increased risk of cerebral palsy and neurodevelopmental impairment. We aimed to describe PNC use in Europe and evaluate the determinants of their use, including neonatal characteristics and adherence to evidence-based practices in neonatal intensive care units (NICUs). METHODS: 3917/4096 (95,6%) infants born between 24 and 29 weeks gestational age in 19 regions of 11 European countries of the EPICE cohort we included...
2017: PloS One
https://www.readbyqxmd.com/read/28067830/bronchopulmonary-dysplasia-chronic-lung-disease-of-infancy-and-long-term-pulmonary-outcomes
#12
REVIEW
Lauren M Davidson, Sara K Berkelhamer
Bronchopulmonary dysplasia (BPD) is a chronic lung disease most commonly seen in premature infants who required mechanical ventilation and oxygen therapy for acute respiratory distress. While advances in neonatal care have resulted in improved survival rates of premature infants, limited progress has been made in reducing rates of BPD. Lack of progress may in part be attributed to the limited therapeutic options available for prevention and treatment of BPD. Several lung-protective strategies have been shown to reduce risks, including use of non-invasive support, as well as early extubation and volume ventilation when intubation is required...
January 6, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28046188/comparative-effectiveness-of-nonsteroidal-anti-inflammatory-drug-treatment-vs-no-treatment-for-patent-ductus-arteriosus-in-preterm-infants
#13
Jonathan L Slaughter, Patricia B Reagan, Thomas B Newman, Mark A Klebanoff
Importance: Patent ductus arteriosus (PDA) is associated with increased mortality and worsened respiratory outcomes, including bronchopulmonary dysplasia (BPD), in preterm infants. Nonsteroidal anti-inflammatory drugs (NSAIDs) are efficacious in closing PDA, but the effectiveness of NSAID-mediated PDA closure in improving mortality and preventing BPD is unclear. Objective: To determine the effectiveness of NSAID treatment for PDA in reducing mortality and moderate/severe BPD at 36 weeks postmenstrual age...
March 6, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28005062/effects-of-delivery-room-quality-improvement-on-premature-infant-outcomes
#14
W Lapcharoensap, M V Bennett, R J Powers, N N Finer, L P Halamek, J B Gould, P J Sharek, H C Lee
OBJECTIVE: Delivery room management interventions have been successfully implemented via collaborative quality improvement (QI) projects. However, it is unknown whether these successes translate to reductions in neonatal morbidity and mortality. STUDY DESIGN: This was a prospective pre-post intervention study of three nonrandomized hospital groups within the California Perinatal Quality Care Collaborative. A collaborative QI model (Collaborative QI) was compared with a single-site QI model (NICU QI) and a non-participant population when implementing evidence-based delivery room practices...
April 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27939123/feeding-methods-at-discharge-predict-long-term-feeding-and-neurodevelopmental-outcomes-in-preterm-infants-referred-for-gastrostomy-evaluation
#15
Sudarshan R Jadcherla, Tanvi Khot, Rebecca Moore, Manish Malkar, Ish K Gulati, Jonathan L Slaughter
OBJECTIVE: To test the hypothesis that oral feeding at first neonatal intensive care unit discharge is associated with less neurodevelopmental impairment and better feeding milestones compared with discharge with a gastrostomy tube (G-tube). STUDY DESIGN: We studied outcomes for a retrospective cohort of 194 neonates <37 weeks' gestation referred for evaluation and management of feeding difficulties between July 2006 and July 2012. Discharge milestones, length of hospitalization, and Bayley Scales of Infant Development-Third Edition scores at 18-24 months were examined...
December 1, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27917436/looking-ahead-where-to-next-for-animal-models-of-bronchopulmonary-dysplasia
#16
REVIEW
Claudio Nardiello, Ivana Mižíková, Rory E Morty
Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth, with appreciable morbidity and mortality in a neonatal intensive care setting. Much interest has been shown in the identification of pathogenic pathways that are amenable to pharmacological manipulation (1) to facilitate the development of novel therapeutic and medical management strategies and (2) to identify the basic mechanisms of late lung development, which remains poorly understood. A number of animal models have therefore been developed and continue to be refined with the aim of recapitulating pathological pulmonary hallmarks noted in lungs from neonates with BPD...
March 2017: Cell and Tissue Research
https://www.readbyqxmd.com/read/27853329/high-flow-nasal-cannulae-versus-nasal-continuous-positive-airway-pressure-in-neonates-with-respiratory-distress-syndrome-managed-with-insure-method-a-randomized-clinical-trial
#17
Maliheh Kadivar, Ziba Mosayebi, Nosrat Razi, Shahin Nariman, Razieh Sangsari
BACKGROUND: In recent years, various noninvasive respiratory support (NRS) of ventilation has been provided more in neonates. The aim of this study was to compare the effect of HFNC with NCPAP in post-extubation of preterm infants with RDS after INSURE method (intubation, surfactant, extubation). METHODS: A total of 54 preterm infants with RDS (respiratory distress syndrome) were enrolled in this study. Using a randomized sequence, they were assigned into two groups after INSURE method...
November 2016: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27783043/progressive-vascular-functional-and-structural-damage-in-a-bronchopulmonary-dysplasia-model-in-preterm-rabbits-exposed-to-hyperoxia
#18
Julio Jiménez, Jute Richter, Taro Nagatomo, Thomas Salaets, Rozenn Quarck, Allard Wagennar, Hongmei Wang, Jeroen Vanoirbeek, Jan Deprest, Jaan Toelen
Bronchopulmonary dysplasia (BPD) is caused by preterm neonatal lung injury and results in oxygen dependency and pulmonary hypertension. Current clinical management fails to reduce the incidence of BPD, which calls for novel therapies. Fetal rabbits have a lung development that mimics humans and can be used as a translational model to test novel treatment options. In preterm rabbits, exposure to hyperoxia leads to parenchymal changes, yet vascular damage has not been studied in this model. In this study we document the early functional and structural changes of the lung vasculature in preterm rabbits that are induced by hyperoxia after birth...
October 24, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27780154/maternal-and-neonatal-outcomes-following-expectant-management-of-preterm-prelabour-rupture-of-membranes-before-viability
#19
Winnie Huiyan Sim, Edward Araujo Júnior, Fabricio Da Silva Costa, Penelope Marie Sheehan
AIM: To assess the contemporary maternal and neonatal outcomes following expectant management of preterm premature rupture of membranes (PPROM) prior to 24 weeks' gestation and to identify prognostic indicators of this morbid presentation. METHODS: We performed a systematic review in the Pubmed and EMBASE databases to identify the primary (perinatal mortality, severe neonatal morbidity and serious maternal morbidity) and secondary (neonatal survival and morbidity) outcomes following expectant management of previable PPROM...
January 1, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/27742002/prevention-and-management-of-bronchopulmonary-dysplasia-lessons-learned-from-the-neonatal-research-network
#20
Kathleen A Kennedy, C Michael Cotten, Kristi L Watterberg, Waldemar A Carlo
Despite remarkable improvements in survival of extremely premature infants, the burden of BPD among survivors remains a frustrating problem for parents and caregivers. Advances, such as antenatal steroids and surfactant replacement, which have dramatically improved survival, have not reduced BPD among survivors. Other advances that have significantly improved the combined outcome of death or BPD, such as vitamin A and avoidance of mechanical ventilation, have had smaller magnitude effects on the outcome of BPD alone...
October 2016: Seminars in Perinatology
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