Bronchopulmonary dysplasia

Bronchopulmonary dysplasia

Bronchopulmonary dysplasia (BPD) or chronic lung disease (CLD) is a typical disease of extremely low birth weight infants (ELBW; birth weight < 1000g) who experienced adverse lung development but were not necessarily exposed to mechanical ventilation (“new” BPD). Originally, BPD was linked to acute respiratory failure (of various origins) and prolonged mechanical…

Perinatal asphyxia

Perinatal asphyxia

Perinatal asphyxia = antepartum or intrapartum hypoxia, hypercapnia and acidosis associated with organ dysfunction (predominantly ventilation, circulation and neurologic impairment) Ventilation changes Compensatory tachypnea => primary apnea => gasping => secondary apnea Gasping causes aspiration of amniotic fluid (possibly with meconium) Continued secretion (absence of reversal) through alveolar-capillary membrane => increased amount of fluid…

Postnatal resuscitation

Postnatal resuscitation

Perinatal asphyxia remains one of the most common indications for postnatal resuscitation. The necessary prerequisites for successful resuscitation are properly equipped rooms (delivery suite, neonatal wards with the right and functional equipment; warmed up to the temperature of 26 °C) with properly trained personnel. Ventilation (and circulation dysfunction) are indications to initiate resuscitation…

Prematurity

Prematurity

Preterm birth is defined as any birth before 37 completed weeks of gestation (37+0). It has been estimated to account for up to 11 % of all births. Preterm birth is a substantial cause of neonatal and pediatric morbidity and mortality. Prematurity is the single most important cause of death in the…

Apnea

Apnea

Apneas represent another important group of respiratory/ventilation dysfunctions in newborns (apart from perinatal asphyxia and respiratory distress syndrome). They are generally defined as a cessation of breathing movements and air flow for more than 20 seconds, thus often being accompanied by desaturation and bradycardia. Spontaneous breathing causes water in lungs to be resorbed into blood and…

Oxygen Therapy

Oxygen Therapy

We should attempt to maintain normoxemic oxygenation in order to prevent hypoxic injury (mainly in the cerebral tissue). On the other hand, oxygen should be carefully titrated to newborns, especially preterm, due to the negative effects associated with its overuse (reactive oxygen species = ROS).  Hyperoxia induces the production of oxygen radicals that subsequently trigger…

Early onset sepsis

Early onset sepsis

Early onset sepsis (EOS) is an infectious complication in newborns that have clinical presentation within the first 72 hours of life. Sometimes also called perinatal due to pathogenesis – vertical transmission shortly before the birth (transplacental), ascendent infection from the cervicovaginal space (chorioamnionitis, funisitis, fetal infection) or during the vaginal delivery. The pathogen can be also the cause…

Chylothorax

Chylothorax

Congenital chylothorax is the most prevalent form of fetal/neonatal hydrothorax. Lymph is generated in the interstitium and carried in lymphatic vessels in a unidirectional flow, joining the venous system near the junction of the left internal jugular and the left subclavian veins. Lymph contains cellular components (lymphocytes), protein, coagulation factors, and…