Related Experiment Videos
The preterm lung and airway: past, present, and future
Richard J Martin1, Avroy A Fanaroff
1Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA. rxm6@case.edu
Pediatrics and Neonatology
|April 20, 2013
Summary
Neonatal intensive care has improved survival from respiratory distress syndrome, but bronchopulmonary dysplasia (BPD) remains a challenge. Research now focuses on minimizing lung injury during birth and understanding long-term respiratory issues like asthma in preterm infants.
Area of Science:
- Neonatology
- Pulmonology
- Developmental Biology
Background:
- Advances in neonatal intensive care have improved survival rates for newborns with respiratory distress syndrome over the past 40-50 years.
- Improved survival has unfortunately been linked to increased long-term morbidity, specifically bronchopulmonary dysplasia (BPD).
- Neonatal lung injury is a significant area of ongoing scientific investigation.
Purpose of the Study:
- To explore the origins of neonatal lung injury, potentially starting in the delivery room.
- To investigate strategies for minimizing oxygen therapy and aggressive ventilation during the fetal-to-neonatal transition.
- To understand the epidemiology and pathogenesis of persistent respiratory morbidities, such as asthma, in preterm survivors.
Main Methods:
- Review of current therapeutic approaches for BPD.
- Analysis of the pro-inflammatory components contributing to BPD.
- Epidemiological and pathogenetic studies on long-term respiratory outcomes in preterm infants.
Main Results:
- Antenatal steroid therapy and selective surfactant therapy are established practices, with ongoing refinement for specific populations.
- Emerging therapies target various aspects of BPD, including its inflammatory pathways.
- There is a recognized need for deeper understanding of the long-term respiratory health of infants who survive neonatal intensive care.
Conclusions:
- While neonatal care has advanced, bronchopulmonary dysplasia (BPD) remains a critical concern.
- Minimizing initial lung injury and developing targeted therapies are key to improving outcomes.
- Further research into the long-term respiratory health, including asthma, of preterm survivors is essential.
Related Concept Videos
01:24Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features
Chronic bronchitis is a key phenotype of chronic obstructive pulmonary disease (COPD), characterized by airway-centered inflammation and mucus overproduction. It develops from long-term exposure to harmful particles or gases, most commonly cigarette smoke, which triggers a persistent inflammatory response.Cellular and Structural ChangesInflammation initially affects the large bronchi and later the smaller airways, with infiltration by immune cells, including neutrophils, macrophages, and...
01:05Breathing
The process of breathing, inhaling and exhaling, involves the coordinated movement of the chest wall, the lungs, and the muscles that move them. Two muscle groups with important roles in breathing are the diaphragm, located directly below the lungs, and the intercostal muscles, which lie between the ribs. When the diaphragm contracts, it moves downward, increasing the volume of the thoracic cavity and creating more room for the lungs to expand. When the intercostal muscles contract, the ribs...
01:23Chronic Obstructive Pulmonary Disease I: Introduction
Chronic obstructive pulmonary disease is a common, preventable, and treatable respiratory disorder characterized by persistent symptoms and progressive airflow limitation. This limitation results from a combination of small-airway disease (obstructive bronchiolitis) and parenchymal destruction (emphysema), both driven by chronic inflammation from exposure to harmful particles or gases.The disease includes two main pathological entities: emphysema, marked by destruction of alveolar walls and...
01:10Atelectasis II: Pathophysiology
Atelectasis develops when alveoli lose their air and collapse inward. Because lung tissue is naturally elastic, these air sacs shrink rather than remaining open. Collapsed alveoli are no longer ventilated, reducing their role in gas exchange. Blood flow may continue in these regions, creating a ventilation–perfusion mismatch. Clinical findings include decreased breath sounds, dullness to percussion, reduced chest expansion, and decreased tactile fremitus as sound transmission through collapsed...
01:30Pneumonia V: Nursing management and Prevention
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
01:29Microbiota of the Respiratory Tract
The human respiratory tract, comprising the upper and lower segments, serves as a critical interface with the external environment. The upper respiratory tract (URT)—including the nostrils, sinuses, pharynx, and oropharynx—is heavily colonized by microbes, while the lower respiratory tract (LRT), composed of the larynx, trachea, bronchi, and lungs, was long thought to be sterile. However, recent molecular studies have revealed that the lungs are not devoid of microbes but act more like...