Title Bronhopulmonalna displazija Title (english) Bronchopulmonary dysplasia Author Lucija Pejić Mentor Ruža Grizelj (mentor)Committee member Daniel Dilber (predsjednik povjerenstva)Committee member Marija Jelušić (član povjerenstva)Committee member Ruža Grizelj (član povjerenstva)Granter University of Zagreb Defense date and country 2016-07-15, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Bronhopulmonalna displazija je česta komplikacija i značajan uzrok dugoročnog pobolijevanja nedonoščadi. Definirana je ovisnošću o dodatnom kisiku u trajanju duljem od četiri tjedna, a ovisno o koncentraciji kisika i stupnju respiratorne potpore, klasificira se kao blaga, umjerena ili teška bolest. Većina nedonoščadi ima blagi oblik bolesti s postupnim oporavkom plućne funkcije. U težim oblicima bolesnici zahtijevaju dugotrajnu mehaničku ventilaciju i oksigenoterapiju, a u najtežim slučajevima ireverzibilno respiratorno zatajenje, najčešće udruženo s trajnom plućnom hipertenzijom i kroničnim plućnim srcem, progredira do smrtnog ishoda. U nastanku bolesti značajnu ulogu ima više čimbenika, poput nasljedne sklonosti, mehaničke ventilacije, oksidativnog stresa i upale, koji remete normalan programirani razvojni slijed nezrelih pluća prijevremeno rođenog djeteta. Prevencija bolesti usmjerena je na sprječavanje rizičnih čimbenika, prije svega prijevremenog poroda, upotrebu neinvazivne respiratorne potpore u liječenju respiratornog distres sindroma, a učinkovitom se pokazala i terapijska primjena vitamina A i kofeina. Liječenje je usmjereno prema minimalno invazivnim tzv. protektivnim metodama mehaničke ventilacije, ciljanim prehrambenim intervencijama uz restrikciju unosa tekućine, dok je primjena glukokortikoida indicirana samo u iznimnim slučajevima. Dugoročne komplikacije bolesti najčešće su vezane uz respiratorni sustav (infekcije, astma ili simptomi slični astmi, restriktivna ili opstruktivna plućna bolest i plućna arterijska hipertenzija), no nerijetko su udružene i s neurorazvojnim oštećenjima i zastojem u rastu. Zbog kronične naravi bolesti i brojnih komorbiditeta, ovi bolesnici zahtijevaju dugotrajno multidisciplinarno praćenje.
Abstract (english) Bronchopulmonary dysplasia is common complication and important cause of long-term morbidity in preterm newborns. It is defined by oxygen requirement for at least four weeks, and depending upon the extent of oxygen supplementation and other respiratory support, it is classified as mild, moderate or severe disease. Most of the preterm newborns have mild form of disease with gradual recovery of pulmonary function. In moderate form patients require prolonged mechanical ventilation and supplemental oxygen. In severe cases due to irreversible respiratory failure, mostly accompanied with pulmonary artery hypertension and pulmonary heart disease it results in death. Various factors play role in pathogenesis of disease, which disrupt normal pulmonary development of preterm newborn, such as genetic predisposition, mechanical ventilation, oxidative stress and inflammation. Prevention of disease is focused on reducing risk factors, primarily on preterm birth and use of noninvasive respiratory support in management of respiratory distress syndrome. Use of vitamin A and caffeine has shown to be effective. Management is directed towards minimal invasive, also known as protective method of mechanical ventilation, specific dietary interventions and fluid restriction, while use of glucocorticoids is indicated in exceptional cases. Long-term consequences of disease are mostly associated with respiratory system (infections, asthma, asthma like symptoms, restrictive or obstructive lung disease and pulmonary artery hypertension), as well with neurodevelopment impairment and growth restriction. Due to chronic nature of disease and numerous comorbidities, these patients require long-term multidisciplinary follow-up.
Keywords
bronhopulmonalna displazija
nedonoščad
ventilacija
prevencija
Keywords (english)
bronchopulmonary dysplasia
preterm newborn
ventilation
prevention
Language croatian URN:NBN urn:nbn:hr:105:930680 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2017-06-26 13:09:17
