Bronchopulmonary Hypertension And Pulmonary Research

The new versus classic BPD features have changed over the years. The approaches to care, including surfactant administration, permissive hypercapnia, and noninvasive ventilation have changed. All these has increased the survival of low birth weight infants as before with classic BPD. The classic BPD was before surfactant and more management techniques, and inflammation and alveolar septal fibrosis. All these changes were associated with oxygen toxicity, infection, and barotrauma.

According to this study, blood was obtained for this research through catheters that were inserted through the umbilical artery and the umbilical vein to obtain the levels of oxygen in blood. The neonates used for this study included neonates in the neonatal intensive care unit. Included in this study were neonates that were born with respiratory distress

Postnatal respiratory complications among newborns are common. The most commonly reported cause of neonatal respiratory distress is transient tachypnea of the newborn (TTN), with an estimated incidence of 1% to 2% of in all newborns.1

Respiratory distress syndrome in premature infants caused by pulmonary surfactant deficiency with incomplete lung development (Santosham et al, 2013). It can also occur as a consequence of neonatal infection (Sinha et al, 2012).

(Cole, 2010) The chest x-ray for these babies generally presents with a ground glass appearance, hyper expanded lung fields with densities and possibly pulmonary edema. Extended periods of use on the mechanical ventilator for preterm and under weight infants can lead to BDP due to decreasing lung compliance from poor perfusion extending from a suspected hypoxemic and hypercapneic state. (ALA, 2008) Even though these babies are on the ventilator, they will still present with shallow breathing, cyanosis, tachypnea, retractions, and scattered rales on the chest x-ray. Later in life, babies who overcome BDP can suffer from developmental problems, poor growth, and possibly pulmonary hypertension. Upon auscultation, there will be coarse rhonchi breath sounds with possible rales, paradoxical breathing and an increase in the rate the patient is breathing. The dynamic lung compliance is reduced hindmost because of the increasing damage that is taking place in the small airway. (ALA, 2008)

Nurse Vincent M. Vacca, Jr. aptly described in this issue of the Nursing Journal the significance of early detection and health management of people who are or are maybe suffering from Pulmonary Arterial Hypertension. He described PAH as a condition wherein a patient is having a mean pulmonary arterial (PA) pressure of greater than 25 mm

The neonatal ARDS disease processes result in lung pathophysiology associated with pulmonary hypertension and poor oxygenation. Conventional mechanical ventilation, surfactant administration, and nitric oxide administrations are the first modalities used in order to increase the tissue perfusion and respiratory insufficiency. When these interventions fail, ECMO will allow for lower ventilator settings, preventing lung injury caused by the ventilator.

In many neonatal intensive care units, the nasal continuous positive airway pressure is a common mode of respiratory support for preterm infants. (Yong et. al., 2005). During my exposure in the neonatal unit, I have noticed that many of the babies are on nasal CPAP. I believe that this a good choice, given the benefits of using the NCPAP for respiratory support. Improved oxygenation and gas exchange, prevention of atelectasis and apnoea, stabilisation of needed functional residual capacity, and surfactant conservation are advantages of using NCPAP according to Newnam et. al. (2013). Xie (2014) further added that NCPAP lowers upper airway resistance and most importantly, it eliminates the use of endotracheal tube and ventilator along with its

As a newborn makes their entrance to this world from intrauterine life all should go smoothly. The newborn is delivered and is stimulated to breathe and then is followed by inspirations, followed by a cry showing a successful arrival to this world, but not all deliveries go as planned. There are diseases of the respiratory system. The most common disease is Respiratory Distress Syndrome (RDS). The Primary cause of RDS is the underdevelopment of the premature lungs states Perretta, 2015. RDS is caused by a deficiency and immaturity of alveolar surfactant with the anatomical immaturity of the premature infants lungs. The incidence of RDS increases with decreasing gestational age says J. Haitsma, 2010. The biggest factor is surfactant deficiency caused by decreased surface area in the lungs for proper gas exchange and thick alveolar-capillary membranes. “Surfactant replacement therapy for preterm infants with RDS has shown to be a major breakthrough in neonatal medicine,” says J. Wirbelauer and Speer, 2009. It has become routine for the prevention and treatment for infants suffering from respiratory distress syndrome. Surfactant replacement therapy is a life-saving treatment for all neonates showing signs of RDS characterized by surfactant deficiency. By replenishing the lungs with an exogenous surfactant shows

Neonatal hypertension develops in 3% of neonates, especially in those admitted to neonatal intensive care. A baby is considered to have HTN if the systolic BP is over the 95th percentile of BP for babies of comparable gestational or postconceptional age and size.24 The major cause of most of the neonatal HTN is renal origin, that includes renovascular and renal parenchymal diseases. The management of HTN was done with antihypertensive medication (labetalol).Care should be provided by the clinical pharmacists in case of neonatal HTN mainly in proper drug selection and dose adjustment.25

These numbers make BPD one of the most common chronic lung diseases diagnosed in children. Infants diagnosed as having BPD are usually born more than 10 weeks before their due day and have low birth weights less than 2 pounds. These preterm infants have pulmonary issues due to underdeveloped lungs and lack of surfactant, which leads to the initial diagnoses of respiratory distress syndrome. The lack of surfactant and collapsed lungs make it difficult for the infant to breathe to get adequate oxygenation. These infants are then treated with surfactant therapy, and they often require extra ventilatory support. If an infant doesn’t improve, they often placed on nasal continuous airway pressure (NCPAP) or ventilators for long periods of time. Studies show that NCPAP can decrease the risk of BPD by generating pressure as well as improving exhalation (Mola, 2014) . If the preterm infant still requires prolonged mechanical ventilation to obtain a PO2 of greater than 50 mmHg at its official due date or 28 days since supplemental oxygen was first applied, additional testing is performed to confirm a true diagnosis of BPD. Infants with BPD often experience abnormal changes in the cells of the smaller airways leading to injured airways and damaged pulmonary vasculature due to the prolonged ventilation. The baby’s

Treatment after birth includes administering prostaglandin E to maintain the ductal patency and pulmonary perfusion. In some cases Blalock-Taussig shunt (BT shunt) can be performed to provide adequate pulmonary blood flow to the lung. Surgeries are done over time from neonates to 4-6 months of age. Mortality depends on the severity of TOF. It carries a 35% mortality rate if left untreated in the first year of life and 50% mortality rate in the first three years of life. Genetic testing to look for these mutations can be a viable option

The purpose of this study was to compare the incidence of BPD and other short-term morbidities seen in VLBW infants who were initiated on VT versus NCPAP as a primary respiratory

Respiratory distress syndrome (RDS) which is presented by higher respiratory rate than normal range for age and other clinical symptoms and signs including grunting, nasal flaring, retraction and cyanosis [5] have a variety of causes in newborn infants and other pediatrics. The main causes of RDS in newborns including lack of pulmonary surfactant in preterm neonates, transient tachypnea of newborns, Meconium aspiration syndrome, infections, pneumothorax due to artificial ventilation and congenital heart disease [5]. Moreover, RDS due to Alveolar surfactant deficiency in preterm neonates considered as the most important cause of death between this group age during first 28 days of life, and it is the main responsible

If your baby is born too soon, there is a good chance that his or her lungs will be underdeveloped. If so, he or she will need to be put onto a ventilator to help with breathing.Your baby may also have trouble maintaining a normal body temperature and will need to be kept warm. If your baby is born too early to suck and swallow, he or she will have to be fed through a needle in a vein or through a tube passed through the nose and throat into the stomach.