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Nutrition and the lung
Jatinder Bhatia1, Anjali Parish
1Section of Neonatology, Department of Pediatrics, Medical College of Georgia, Augusta, GA 30912, USA. jatindeb@mcg.edu
Insights
Despite advances in respiratory support for premature infants, chronic lung disease remains prevalent. Nutritional therapy may offer a promising adjunctive approach for these vulnerable newborns.
Area of Science:
- Neonatology
- Pediatric Critical Care
- Pulmonology
Background:
- Improved survival rates for very-low-birth-weight infants have been achieved through surfactant replacement, gentle ventilation, and prenatal corticosteroids.
- However, these interventions have not decreased the incidence of chronic lung disease, a condition with significant long-term healthcare costs.
- Perinatal malnutrition is a persistent challenge in the care of premature infants.
Purpose of the Study:
- To review the role of nutrition therapy in lung health and disease, particularly in premature infants.
- To explore potential adjunctive benefits of nutritional interventions for chronic lung disease in neonates.
Main Methods:
- Literature review focusing on nutritional interventions and their impact on lung development and disease.
- Analysis of existing data on the efficacy and safety of nutritional strategies in premature infants.
- Synthesis of information regarding the relationship between nutrition and lung function in the perinatal period.
Main Results:
- Current therapies for chronic lung disease in premature infants have not demonstrated long-term efficacy or preventative capabilities.
- Nutritional therapy is intuitively considered beneficial but remains an area requiring further investigation.
- The prevalence of prematurity and survival rates contribute to the escalating costs associated with managing established chronic lung disease.
Conclusions:
- Established therapies have limitations in addressing chronic lung disease in premature infants.
- Nutritional therapy presents a potential avenue for adjunctive treatment, warranting further research.
- Addressing perinatal malnutrition is crucial for improving outcomes in sick premature infants.
Abstract:
The use of surfactant replacement, 'kinder gentler' modes of ventilation combined with prenatal corticosteroids have all played a role in improved survival rates of very-low-birth-weight infants but have not reduced the prevalence of chronic lung disease. The increased rates of prematurity being observed in the United States along with the increased survival makes the overall problem of treatment of infants with established disease expensive spanning neonatology, pediatric critical care and general pediatrics and involving a myriad of specialists over the life of the surviving infant. However, none of the therapies used over the years have proven to be effective or have long-term adverse effects, nor have they been accepted as methods to prevent chronic lung disease. Although intuitively an appropriate nutritional therapy may be a useful adjunct in the care of the premature sick infant, perinatal malnutrition remains a major problem. The role of nutrition therapy in health and disease as it pertains to the lung will be reviewed.
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