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Title: | Chronic lung disease in preterm neonates. | Authors: | Yu V.;Tan J.-B. | Institution: | (Yu) Department of Pediatrics, Ritchie Centre for Baby Health Research, Monash University, 246 Clayton Road, Clayton, VIC 3168, Australia (Tan) Newborn Services, Monash Medical Centre, Clayton, VIC, Australia | Issue Date: | 17-Oct-2012 | Copyright year: | 2007 | Publisher: | Institute of Pediatrics of Zhejiang University (57 Zhugan Xiang, Hangzhou 310003, China) | Place of publication: | United States | Publication information: | World Journal of Pediatrics. 3 (3) (pp 170-186), 2007. Date of Publication: August 2007. | Abstract: | Background: With advances in neonatal intensive care, increasing numbers of preterm neonates are now surviving. In the past they would have died before there was time to develop chronic lung disease (CLD). Based on the definition of a neonate requiring any form of respiratory therapy (oxygen or assisted ventilation) at 36 weeks' post-menstrual age, the CLD rate in Australia is 52% in those <28 weeks and 12% in those 28-32 weeks gestation. The high CLD rate in the former group is due to their improved survival rates (one-year survival rate of infants born in the State of Victoria is 41% at 23 and 24 weeks, 73% at 25 weeks, and 88% at 26 weeks). Data sources: Randomized controlled trials (RCTs), including meta-analyses and Cochrane reviews on the prevention and treatment of CLD were identified in the published literature. Result(s): The following perinatal strategies were found to be effective in preventing or minimizing CLD: antenatal corticosteroids, postnatal surfactant, reduced oxygen saturation targeting at 89%-94%, early use of continuous positive airway pressure, synchronized ventilation, permissive hypercapnia ventilation strategy, high frequency oscillatory ventilation, closure of symptomatic patent ductus arteriosus with indomethacin, reduced fluid intake, and inhaled nitric oxide. Several anti-inflammatory and anti-oxidant agents have been found in RCTs to be effective, including vitamin A and recombinant human superoxide dismutase. Clinical management after the development of CLD includes appropriate oxygen and ventilation strategies, fluid restriction, and diuretic and bronchodilator therapy. Postnatal corticosteroid therapy is efficacious but its side-effect is increasing. The risk of cerebral palsy outweighs the benefit of therapy. Only in severe CLD, low-dose and short-course dexamethasone should be used. Conclusion(s): Ongoing basic and clinical research is required to identify perinatal and neonatal interventions that are effective in either preventing or treating CLD in preterm neonates. © 2007, World J Pediatr. All rights reserved. | ISSN: | 1708-8569 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/31781 | Type: | Article | Subjects: | *chronic lung disease/pc [Prevention] *chronic lung disease/th [Therapy] clinical trial Cochrane Library diet supplementation disease association diuresis drug dose reduction drug potentiation duodenum perforation/si [Side Effect] echocardiography electrolyte disturbance/si [Side Effect] evidence based medicine family history fiberoptic bronchoscopy gastroduodenal ulcer/si [Side Effect] gastrointestinal symptom/dt [Drug Therapy] gastrointestinal symptom/pc [Prevention] genetic polymorphism genetic predisposition glucose intolerance/si [Side Effect] human hypercalciuria/si [Side Effect] hypertension/si [Side Effect] hypertrophic obstructive cardiomyopathy/si [Side Effect] incidence interstitial pneumonia intrauterine infection kidney calcification/si [Side Effect] leukomalacia/si [Side Effect] lipid diet long term care magnesium deficiency meta analysis monotherapy nebulization nephrolithiasis/si [Side Effect] newborn intensive care oxygen therapy oxygen toxicity/co [Complication] patent ductus arteriosus pathogenesis pertussis/dt [Drug Therapy] pertussis/pc [Prevention] positive end expiratory pressure *prematurity/dt [Drug Therapy] *prematurity/pc [Prevention] prognosis protein degradation pulmonary hypertension/co [Complication] pulmonary hypertension/di [Diagnosis] pulmonary hypertension/dt [Drug Therapy] pulmonary hypertension/pc [Prevention] respiratory tract infection retinol deficiency/dt [Drug Therapy] retinol deficiency/pc [Prevention] risk benefit analysis secondary hyperparathyroidism/si [Side Effect] selenium deficiency sepsis/si [Side Effect] side effect/si [Side Effect] systematic review therapy delay tidal volume urea nitrogen blood level virus infection/dt [Drug Therapy] beclometasone dipropionate/dt [Drug Therapy] bronchodilating agent/dt [Drug Therapy] chlorothiazide/cb [Drug Combination] chlorothiazide/dt [Drug Therapy] chlorothiazide/po [Oral Drug Administration] corticosteroid/cb [Drug Combination] corticosteroid/dt [Drug Therapy] dexamethasone/ae [Adverse Drug Reaction] dexamethasone/ct [Clinical Trial] dexamethasone/do [Drug Dose] dexamethasone/dt [Drug Therapy] dexamethasone/pd [Pharmacology] diuretic agent/cb [Drug Combination] diuretic agent/it [Drug Interaction] diuretic agent/dt [Drug Therapy] furosemide/ae [Adverse Drug Reaction] furosemide/cb [Drug Combination] furosemide/dt [Drug Therapy] furosemide/iv [Intravenous Drug Administration] furosemide/po [Oral Drug Administration] helium/dt [Drug Therapy] hydrochlorothiazide/cb [Drug Combination] hydrochlorothiazide/dt [Drug Therapy] hydrochlorothiazide/po [Oral Drug Administration] indometacin/ct [Clinical Trial] indometacin/dt [Drug Therapy] ipratropium bromide/dt [Drug Therapy] isoetarine/dt [Drug Therapy] isoprenaline/dt [Drug Therapy] nifedipine/dt [Drug Therapy] nifedipine/po [Oral Drug Administration] nitric oxide/dt [Drug Therapy] nitric oxide/ih [Inhalational Drug Administration] orciprenaline/dt [Drug Therapy] oxygen pertussis vaccine/dt [Drug Therapy] protirelin/cb [Drug Combination] protirelin/dt [Drug Therapy] ranitidine/dt [Drug Therapy] ranitidine/iv [Intravenous Drug Administration] recombinant erythropoietin/dt [Drug Therapy] retinol/dt [Drug Therapy] ribavirin/dt [Drug Therapy] salbutamol/ae [Adverse Drug Reaction] salbutamol/ad [Drug Administration] salbutamol/dt [Drug Therapy] salbutamol/iv [Intravenous Drug Administration] salbutamol/po [Oral Drug Administration] sildenafil/dt [Drug Therapy] spironolactone/cb [Drug Combination] spironolactone/dt [Drug Therapy] spironolactone/po [Oral Drug Administration] steroid/ct [Clinical Trial] steroid/dt [Drug Therapy] steroid/ih [Inhalational Drug Administration] steroid/pd [Pharmacology] theophylline/cb [Drug Combination] theophylline/it [Drug Interaction] theophylline/dt [Drug Therapy] unindexed drug uterus spasmolytic agent/dt [Drug Therapy] lung compliance amino acid blood level antioxidant activity article artificial ventilation balloon dilatation body weight disorder/si [Side Effect] bronchospasm cardiovascular disease/si [Side Effect] cholelithiasis/si [Side Effect] chorioamnionitis *chronic lung disease/cn [Congenital Disorder] *chronic lung disease/di [Diagnosis] *chronic lung disease/dt [Drug Therapy] *chronic lung disease/et [Etiology] *chronic lung disease / *congenital disorder / *diagnosis / *drug therapy / *etiology / *prevention / *therapy clinical trial Cochrane Library diet supplementation disease association diuresis drug dose reduction drug potentiation duodenum perforation / side effect echocardiography electrolyte disturbance / side effect evidence based medicine family history fiberoptic bronchoscopy gastroduodenal ulcer / side effect gastrointestinal symptom / drug therapy / prevention genetic polymorphism genetic predisposition glucose intolerance / side effect human hypercalciuria / side effect hypertension / side effect hypertrophic obstructive cardiomyopathy / side effect incidence interstitial pneumonia intrauterine infection kidney calcification / side effect leukomalacia / side effect lipid diet long term care lung compliance magnesium deficiency meta analysis monotherapy nebulization nephrolithiasis / side effect newborn intensive care oxygen therapy oxygen toxicity / complication patent ductus arteriosus pathogenesis pertussis / drug therapy / prevention positive end expiratory pressure artificial ventilation prognosis protein degradation pulmonary hypertension / complication / diagnosis / drug therapy / prevention respiratory tract infection retinol deficiency / drug therapy / prevention risk benefit analysis secondary hyperparathyroidism / side effect selenium deficiency sepsis / side effect side effect / side effect systematic review therapy delay tidal volume urea nitrogen blood level virus infection / drug therapy article antioxidant activity amino acid blood level *prematurity / *drug therapy / *prevention balloon dilatation body weight disorder / side effect bronchospasm cardiovascular disease / side effect cholelithiasis / side effect chorioamnionitis |
Type of Clinical Study or Trial: | Systematic review and/or meta-analysis |
Appears in Collections: | Articles |
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