OrphanAnesthesia – A common project of the scientific working group of paediatric anaesthesia of the German society of anaesthesiology and intensive care medicine

Marissa Vadi, Mathew Malkin, Ryan Lauer, Anne Greenough, Kathleen M. Deakins

Research output: Contribution to journalArticle

Abstract

Disease summary: Bronchopulmonary dysplasia (BPD) is a chronic lung disease that remains one of the most prevalent long-term sequelae of premature birth. Northway and colleagues first described the condition in 1967, after 32 preterm infants (mean gestational age 34 weeks) with respiratory distress syndrome developed characteristic radiographic changes following the initiation of positive pressure mechanical ventilation [1]. Four stages of lung injury were described in “classic” BPD: exudative (age 1–3 days); necrosis and early repair (age 4–10 days); microcyst formation and pulmonary fibrosis (age 10–12 days); and severe cystic changes and cor pulmonale (after 30 days of age) [2]. The clinical definition of BPD has evolved with time and advancements in neonatal care including surfactant therapy, antenatal steroid administration, and improved ventilator strategies [3,4]. Most infants currently developing BPD are born between 24-28 weeks gestational age, during the time of canalicular and saccular development. “New” BPD is characterised by a uniform arrest of lung development, with simplified alveolar structures and dysmorphic capillaries. These infants are more likely to present with a mild respiratory distress syndrome and a continued need for supplemental oxygen [5]. Three levels of BPD severity (mild, moderate, or severe) are determined by the gestational age of the infant, oxygen dependency at 36 weeks post-conceptual age, total duration of oxygen supplementation, and positive pressure requirements [6]. Long-term BPD survivors may experience persistent airway obstruction and pulmonary hypertension, complicating anaesthetic management.

Original languageEnglish (US)
Pages (from-to)S448-S455
JournalAnasthesiologie und Intensivmedizin
Volume60
Issue number9
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

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Bronchopulmonary Dysplasia
Anesthesiology
Critical Care
Anesthesia
Medicine
Pediatrics
Gestational Age
Oxygen
Pulmonary Heart Disease
Positive-Pressure Respiration
Pulmonary Fibrosis
Premature Birth
Lung Injury
Airway Obstruction
Mechanical Ventilators
Artificial Respiration
Pulmonary Hypertension
Premature Infants
Surface-Active Agents
Lung Diseases

Keywords

  • Chronic lung disease of prematurity

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Anesthesiology and Pain Medicine

Cite this

OrphanAnesthesia – A common project of the scientific working group of paediatric anaesthesia of the German society of anaesthesiology and intensive care medicine. / Vadi, Marissa; Malkin, Mathew; Lauer, Ryan; Greenough, Anne; Deakins, Kathleen M.

In: Anasthesiologie und Intensivmedizin, Vol. 60, No. 9, 01.01.2019, p. S448-S455.

Research output: Contribution to journalArticle

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