Bronchopulmonary Dysplasia and its future
The diagnosis of bronchopulmonary dysplasia in very preterm infants utilizing respiratory support was made at 36 weeks postmenopausal age, independent of the prior duration of current oxygen therapy levels.
Optimal diagnostic criteria were defined a priori as that of BPD, resulting in the highest c-statistic for the primary endpoint of the study. The assessed respiratory parameters are consistent with several previous studies exploring the incidence of respiratory illness after discharge in very preterm infants and represent meaningfully established adverse outcomes for parents and health care providers.
Note that the hypoxia test was not used to determine oxygen dependence in this analysis, as only 57% (452 out of 791) of eligible infants were tested.
Although future studies should further evaluate the validity of these new diagnostic criteria, our results provide a solid rationale for using the definition described in the review. this is a modern criterion based on the severity of BPD.
Among the best-characterized growth factors and their signalling components during early lung development are fibroblast growth factor, transforming growth factor β, bone morphogenetic protein, sonic porcupine, the family of wingless-type MMTV integration sites, vascular endothelial growth factor, and the retinoic acid signalling pathway. It is difficult to pinpoint which exposure is most detrimental to lung development.
In the developing lung, where extensive micro vascularization is critical for lung function, resident lung MSCs are a heterogeneous population of progenitors that coordinate alveolar microcirculation, repair/ tissue regeneration and maintenance.
The efflux of these macrophages, which express the M2 phenotype or are alternately activated, and locate at branch sites of the developing lung, suggest that they are likely to contribute to the development of the alveolar lung.
The composition of the lung microbiome changes and stabilizes during the first month of life, but there are marked differences in the lungs of children and adults with lung disease.
Associated chorioamnionitis and BPD. The beneficial effects of the lung microbiota and specifically of lactobacilli on lung development are supported by a mouse study where there was a positive correlation between microbial abundance and growth. of the lungs.
What is bronchopulmonary dysplasia?
Some infants, especially premature babies and infants with respiratory distress syndrome at birth, have underdeveloped lungs. As a result, they may need respiratory treatment, such as mechanical ventilation. BPD can also damage the blood vessels inside the lungs, making it harder to transport oxygen to and from the lungs through the blood. This damage to the developing lungs can cause persistent breathing problems. During the first year of life, 50% of babies with BPD have to return to the hospital after birth.
Cause
BPD occurs when a baby's undeveloped lungs need treatment such as mechanical ventilation. This aggressive treatment can damage the developing alveoli of the lungs. Although mechanical ventilation is the immediate cause of BPD, many risk factors increase the risk of needing mechanical ventilation. These risk factors include preterm birth, especially if the baby was not given steroid injections before birth, hypoxia at birth, genetic abnormalities of the lungs, respiratory failure, poor nutrition, at birth. the baby's risk of having BPD. These include infections and complications caused by pregnancy, such as preeclampsia.
Symptoms
Doctors diagnose BPD based on problems with the baby's developing lungs. Premature babies with respiratory failure who are still having difficulty breathing at 36 weeks are more likely to have BPD. Symptoms vary depending on the severity of the disease, the age at birth, the treatment the baby is receiving, and other factors. However, the most common signs and symptoms are pulmonary hypertension, which is high blood pressure in the lungs. has been significantly improved. Even premature babies have a high chance of survival. Greater awareness of the risks associated with BPD has also reduced its popularity. A 2016 analysis looking at data from very premature babies between 2006 and 2010 found that 75% of babies born between 23 and 24 weeks develop BPD and 73.9% survive. Among those born between 25 and 26 weeks, the outcome was even better, with 41.7% BPD and 85.1% survival. Even after treatment and discharge, infants with BPD can have persistent problems because BPD damages the lungs. Premature birth is also a risk factor for growth retardation.
