[Chronic lung disease of the neonate; pathophysiology and treatment after the first weeks of life].
Chronic lung disease of the neonate sometimes occurs as a residual condition following respiratory distress in preterm infants. Improvements in neonatal intensive care treatment will in future lead to a greater number of children surviving chronic lung disease and reaching adulthood. The symptoms of the disease are hypoxaemia, hypercapnia, tachypnoea, subcostal and intercostal retractions, fluid retention, a reduced exertion tolerance and hyperreactive airways. The treatment after the first weeks of life is symptomatic and consists of: providing supplemental oxygen via a nasal mask or cannula (0.1-1 l/min); rapid downward adjustment of oxygen therapy may lead to more complaints and poorer growth; a normal fluid therapy; if there is a tendency towards fluid retention, then diuretic therapy is indicated and in severe cases fluid restriction as well; in the case of bronchial hyperreactivity: inhaled corticosteroids (the lowest effective dose for a period of several months) and a trial treatment with beta-agonists; in the case of persistent complaints or functional limitations, lung function tests can distinguish obstructive and restrictive disorders; vaccinations according to the national programme; consider vaccinations against influenza (age: 6-12 months) and respiratory syncytial virus (age < 2 years).
Vrijlandt
E J
EJ
Sectie Kinderlongziekten, Academisch Ziekenhuis, Beatrix Kinderkliniek, Hanzeplein 1, 9713 GZ Groningen.
Duiverman
E J
EJ
Bos
A F
AF
D002908:Chronic Disease; D005183:Failure to Thrive / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D008171:Lung Diseases / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D010102:Oxygen Inhalation Therapy; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000209:etiology; D012307:Risk Factors