BPD in premature infants - what is it?

Bronchopulmonary dysplasia (BPD) in premature infants develops against the background of prolonged exposure to high oxygen pressure created by the artificial respiration apparatus. To eliminate the ailment, the baby needs special therapy aimed at saving his life. Let us consider in more detail what are these, the causes, symptoms and peculiarities of the treatment of a pathological phenomenon.

BPD in premature infants - what is it?

Babies born several years before the due date are exposed to various diseases due to insufficient development of internal organs. Practically every such child has serious deviations in the work of the respiratory system. To maintain the required level of oxygen, the baby is connected to the apparatus of artificial ventilation. This is a modern equipment that controls the humidity, temperature and speed of the gas mixture for breathing. A frequent complication after this procedure is bronchopulmonary dysplasia.

BPD in premature infants develops under the influence of a high concentration of oxygen for a long time. If the child has been on ventilator for more than 28 days, the risk of the appearance of pathology is significantly increased. Rarely does the ailment occur in children born on time, after suffering severe bronchial and lung diseases.

At present, cases of a new type of BPD are more often recorded, in which the baby's lungs have minimal alveolarization, less pronounced lesion of the respiratory system and pulmonary vessels. In comparison with the "classical" bronchopulmonary dysplasia, the "mild" form of the disease is much easier to transfer.

Causes of BPD

Cases of bronchopulmonary dysplasia occur after the child is disconnected from artificial ventilation. Experts argue that a pathological phenomenon arises because of the effect of pure oxygen on insufficiently developed lung structures. The main risk factors for the development of BPD include the following:

• Getting into the bronchopulmonary system of infectious agents;
• Incorrect introduction of surfactant;
• Pulmonary hypertension caused by heart disease;
• Damage to the lung tissue when connected to the ventilator;
• pulmonary edema;
• Hypovitaminosis.

Particularly common is BPD in deeply premature babies. This category includes babies born before 29 and weighing less than 1500 g. The surfactant system is not fully developed in them. This leads to the fact that during exhalation the alveoli of the lungs begin to stick together and are damaged, which provokes a worsening of gas exchange. To prevent undesirable consequences, the child is connected to the ventilator.

Symptoms of BPD

The first manifestation of the disease is fixed after the baby is disconnected from the respirator. Immediately it may seem that the child has a positive dynamics, but after a while there are dangerous signals. First of all, parents should pay attention to rapid breathing. If the baby does more than 60 breaths per minute, the wings of the nose swell, and the chest has a barrel-like appearance, you need to seek medical help as soon as possible.

Noisy breathing, sputum in the lungs, prolonged exhalation, blueing of the skin - frequent symptoms of BPD in premature infants. What is this ailment and how to alleviate the condition of the child? Therapy is selected only by a doctor, depending on the severity of the baby's condition. Preliminary diagnostic actions are carried out: external examination, ultrasound of the heart, lung X-ray. In addition, laboratory tests, consultation of a pulmonologist may be prescribed.

Treatment of BPD

In premature infants, pathology is treated symptomatically. The main task of such therapy is to stop the signs of the disease and normalize breathing. Duration of treatment - from several weeks to 2-3 months.

There are light, medium and heavy forms of bronchopulmonary dysplasia. During the course of the disease, there are stages of exacerbation and remission. Drug therapy implies the use of glucocorticoids, diuretics, antibiotics (if necessary), bronchodilators, surfactants.

Antibacterial drugs are necessary to suppress the development of the inflammatory process. Optimal drugs are considered to be from the group of macrolides, which effectively fight a wide spectrum of pathogenic pathogens.

Features of therapy

Despite the fact that the ailment provokes artificial ventilation of the lungs, oxygen therapy will be required during the treatment. Connecting the baby to the device is necessary to provide the respiratory system and all tissues with sufficient oxygen. At the same time, the concentration of the gas mixture and the pressure in the equipment are minimized. It will also require constant monitoring of the amount of oxygen in the blood of the child.

With BPD, preterm infants require a diet. It is important to provide the baby's body with enough protein and at the same time not to allow excess fluid. If the condition of the baby is heavy, the nutrient mixture is injected through the probe. The volume of the liquid is reduced to 110 ml per kg of weight per day to prevent the development of pulmonary edema.

The use of hormonal drugs

Hormonal therapy is necessary to eliminate the inflammatory process in the respiratory tract, which occurs against the background of bronchopulmonary dysplasia. Systemic glucocorticoids are prescribed from the first days of life when the child is on artificial ventilation. This reduces the risk of severe respiratory system pathologies.

It should be borne in mind that hormone therapy has a number of disadvantages, the main of which are side effects in the form of hyperglycemia, hypertension, hypertrophic cardiomyopathy.

Preference is often given to inhaled steroids. They require a much lower dosage and affect only the lower parts of the respiratory tract. At the same time, such therapy has only a temporary positive effect in severe cases.

"Dexamethasone" is one of the most effective and fast-acting drugs from the group of glucocorticoids. He is appointed in emergency cases for the removal of acute manifestations of pathology. Also, the drug prevents the emergence of new seizures.

Treatment of BPD in premature babies "Dexamethasone" allows to suppress the action of interleukin - a biologically active substance entering the bronchial region and participating in inflammatory processes. The drug prevents the development of respiratory failure and is completely safe for the child.

Dexamethasone: Description of the preparation

Medication is a powerful synthetic agent of the glucocorticoid series. The action of "Dexamethasone" is aimed at the normalization of protein, mineral and carbohydrate metabolism in the body. It has strong anti-inflammatory, anti-allergic, antitoxic and anti-shock properties. The inflammatory process can be stopped due to a significant reduction in the synthesis of mast cells and eosinophils, which produce inflamed mediators.

For the treatment of bronchopulmonary dysplasia in children, a solution in ampoules is used. Dosage is selected exclusively on an individual basis. It should be borne in mind that short-term use of the drug has an immunosuppressive effect, and with prolonged therapy, the risk of secondary infection increases.

Diuretics in BPD

Despite a decrease in daily fluid intake in preterm infants with BPD, diuretics are prescribed to prevent the onset of edema. Their therapeutic effect is aimed at normalizing the acid-base balance and reducing the amount of fluid in the tissues.

Among systemic diuretics, Furosemide is most commonly used. The purpose of this drug is to accelerate the reabsorption of fluid in the lungs and improve pulmonary mechanics in swelling.

Forecasts and implications

Bronchopulmonary dysplasia is a rather serious and dangerous disease. In severe form, the disease leads to a lethal outcome in 20% of cases. In the light and moderate course of the pathology, the improvement of the baby's condition can be achieved during the first months of life. How often do negative consequences develop after BPD in premature infants? Experts say that such babies suffer from infectious diseases of the respiratory system, high blood pressure, anemia, delayed physical development.