What is chronic lung disease?
Chronic lung disease (CLD) is a general term for long-term respiratory issues in premature babies. It is likewise known as bronchopulmonary dysplasia (BPD).
Babies with CLD need to be managed carefully. They are at risk for fluid build-up in the lungs, they tire out quickly from the effort needed to breathe, and they may have other conditions that make CLD more of a challenge.
What causes chronic lung disease?
CLD results from lung injury to babies who must use a mechanical ventilator and extra oxygen for breathing. The lungs of newborn (and especially premature) babies are fragile and are quickly damaged. With injury, the tissues inside the lungs end up being irritated and can break down triggering scarring. This scarring can result in problem breathing and increased oxygen needs. Some of the causes of lung injury include the following:
- Prematurity. The lungs, particularly the air sacs, are not totally developed.
- Low quantities of surfactant (a compound in the lungs that assists keep the small air sacs open).
- Oxygen use (high concentrations of oxygen can harm the cells of the lungs).
- Mechanical ventilation. The pressure of air from breathing makers, suctioning of the airways, and use of an endotracheal tube. (ET tube is a tube positioned in the trachea and connected to a breathing device.).
Who is impacted by chronic lung disease?
Chronic lung disease can develop in premature babies who have actually had mechanical ventilation (breathing machine). Risk factors for establishing CLD include:
- Birth at less than 30 weeks gestation.
- Birthweight less than 1,000 (less than 2 pounds) to 1,500 grams (3 pounds 5 ounces).
- Baby respiratory distress. Lung disease of prematurity due to absence of surfactant.
- Pulmonary interstitial emphysema (PIE). A problem in which air leakages from the air passages into the areas in between the small air sacs of the lungs.
- Patent ductus arteriosus (PDA). A connection in between the blood vessels of the heart and lungs that does not close as it must after birth.
- Premature white, male babies are at greater risk for developing chronic lung disease.
- Maternal womb infection (chorioamnionitis).
- A family history of asthma.
- Breathing issues at birth.
- Development of an infection during or soon after birth.
What are the symptoms of chronic lung disease?
The following are the most typical symptoms of CLD. However, each baby might experience different symptoms of the condition. Symptoms might consist of:
- Breathing distress (fast breathing, flaring of the nostrils, groaning, chest retractions).
- Continued requirement for mechanical ventilation or oxygen after a premature baby reaches 36 weeks gestation.
The symptoms of CLD might resemble other conditions or medical issues. Always consult your baby’s doctor for a medical diagnosis.
How is chronic lung disease diagnosed?
Because CLD is a chronic disease and appears gradually, doctors must look at numerous elements. It is typically diagnosed when a premature baby with breathing problems continues to need extra oxygen after reaching 28 days of age. Chest X-rays compared to previous X-rays might show modifications in the appearance of the lungs. The X-ray of lungs with CLD often has a bubbly, sponge-like appearance. X-rays are diagnostic tests that use invisible electro-magnetic energy beams to produce pictures of internal tissues, bones, and organs onto film.
Blood tests (test used to identify if adequate oxygen remains in the blood) and an echocardiography (test that use acoustic waves to produce pictures of the heart to dismiss flaws) are likewise used to confirm causes of bronchopulmonary dysplasia.
Treatment of chronic lung disease
Particular treatment for CLD will be determined by your baby’s doctor based upon:
- Your baby’s gestational age, general health, and case history.
- Level of the disease.
- Your baby’s tolerance for particular medications, procedures, or therapies.
- Expectations for the course of the disease.
- Your viewpoint or preference.
Treatment of CLD might consist of:
- Additional oxygen (to make up for the reduced breathing capability of the harmed lungs) and a pulse oximeter to determine how much oxygen remains in the blood.
- Mechanical ventilation with progressive weaning as the baby’s lungs grow and can do more of the work of breathing.
- Surfactant replacement.
- Medications such as:
- Bronchodilators (to assist open the airways).
- Steroids (to assist to minimize inflammation).
- Diuretics (to help minimize excess fluid in the lungs).
- Antibiotics (to eliminate an infection).
- Intravenous fluids and nutrition (to assist the baby and the lungs grow). It is very important to monitor the fluid consumption, since excess fluids can build up in the lungs and worsen the infant’s breathing capability.
- Glowing warmers or incubators to keep the infant warm and decrease the dangers of establishing an infection.
- Nutrition (to assist the baby and the lungs grow).
- Immunization against lung infection by respiratory syncytial infection and influenza.
CLD can be a long-term condition. Some babies with CLD require mechanical ventilators for a number of months. Some babies will continue to need oxygen when they go home from the health center, but the majority of can be weaned from oxygen by the end of their first year. Babies with CLD may be at increased risk for breathing infection and might need to be rehospitalized.