Bronchopulmonary Dysplasia Flashcards Preview

Respiratory 1 > Bronchopulmonary Dysplasia > Flashcards

Flashcards in Bronchopulmonary Dysplasia Deck (27)
Loading flashcards...
1
Q

BPD definition

A

BPD is inflamm lung dz of premature infants that results in arrested lung development and can be fatal for premature babies that are severely affected

Late canalicular and saccular development

2
Q

Risk factors of BPD

A

Genetics, chorioamnionitis, PTL

Mech ventilation, immunology and infalmmation, O2, nosocomial infection

3
Q

Mechs for BPD

A

Premature lungs
Antenatal insults
POst-natal insults
Premature immune system

4
Q

Mechanical ventilation effect

A

Damage the primary septa

5
Q

Antenatal infections

A

40% clinical if less than 28 weeks

80% less than 28 weeks

Most common is ureaplasma

6
Q

Genetics and BPD

A

TNF-308 SNPs possibly associated

Some populations are more at risk

7
Q

IMmature lungs and ventilator

A

Acute lung injury is first step in proces of arrested lung development**

Inflam response is decreased in early but prolonged late

Loss of secondary creast has LT sequeal

ALI more likely to lead to fibrosis

Less compiant

More ventilator induced injury

8
Q

Injury in the lungs

A

Microfracture of the type 1 cells lining the lungs with more pressure…produce cytokines that activate resident macrophages nad neutrophils to come to the lungs…amount of neutrophils in periphery could be decreased…

9
Q

Cytokine response

A

TNF-alpha, IL6,1,and 8 are pro

Anti is minimal - IL10

10
Q

Cyclic stretch

A

Cytokine mediated response

Increase ROS and RNS (ind of hyperoxia)

Mediated through NADPH oxidase activity

Tx with antioxiants????

11
Q

Protease and ox contribution

A

Elastase and MMP from PMNs

Free rads

More vascular permabiliy

12
Q

O2 toxicity

A

Premature lung lacks a lot of antoxidant enzyme defense (SOD)

13
Q

LT sequela

A

LEads to scarring because increase TGF alpha and beta and decreased VEGF

Fibrosis, less sepatation and vascular growth

14
Q

BPD typically follows

A

Mech ventilation…most 10-14 days

15
Q

Severe ALI is

A

ARDS

ALI is long term CLD and BPD

16
Q

Types of trauama

A

Underdistenstion - atelectrauam

Over - volutrauam

17
Q

Atelectrauma

A

High peak pressures = shear stress…alveolar damage and inflam response…lung injury

Poor volume also associated with decreased surfactant production

18
Q

Volutrauama

A

Over distension results in microfracture

High tidal volume ventilation associated with increased perability

19
Q

Postnatal infections

A

Early onset sepsis increases rate of BPD

20
Q

Nutrition tx for BPD

A

Insufficient can increase vulnerability to ox inducent lung injury

Vit A?

21
Q

Delivery room oxygen

A

Use 30% oxygen vs. 90% to decrease incidence of BPD and target lower O2 saturations

22
Q

Ventilation and BPD tx

A

Non-invasive
Bubble CPAP
Low tidal volume
PEEP to maintain LV

23
Q

FLuid admin and BPD

A

Failure to lose weight during first week associated with hgiher BPD

Early fluid admin associated with increased BPD

24
Q

Diuretics and BPD

A

Furosemide can improve lung compliance and oxygenation on a short term basis

25
Q

Post natal steroids and BPD

A

Early decrease incidene of BPD by 10-30%

Late has less effect

Increased risk of bowel perforations
in first 2 weeks

LT neurodevelopmental problems…7-8 years of age

INhaled initate less than 2 weeks…no effect on CLD

26
Q

Caffeine

A

Reduction in incidene of CLD

27
Q

Outcome of BPD

A

Increased airway obstruction…especially common earlier

Altered FRC and RV…decreased FEV1 and decreased exercise capacity

Adults have emphysema on CT scan