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The Perinatal Asphyxiated Lamb Model: A Model for Newborn Resuscitation
Published on: August 15, 2018
Principles of resuscitation for infants with severe bronchopulmonary dysplasia
Summer Elshenawy1, Monique R Radman-Harrison2, Philip T Levy3
1Division of Neonatology, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine Atlanta, Georgia, USA.
Insights
Severe bronchopulmonary dysplasia (sBPD) is a complex lung disease in premature infants. Understanding its phenotypes and phases guides targeted resuscitation during acute decompensation.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Critical Care Medicine
Background:
- Severe bronchopulmonary dysplasia (sBPD) is a common, heterogeneous lung disease in premature infants, associated with significant morbidity and mortality.
- sBPD presents with overlapping cardiac, airway, pulmonary vascular, and infectious phenotypes, progressing through distinct phases of care.
- Premature infants with sBPD face a high risk of acute decompensation and cardiopulmonary arrest.
Purpose of the Study:
- To provide a comprehensive overview of sBPD phenotypes and care phases.
- To identify common triggers for acute exacerbations in sBPD.
- To outline principles and a framework for resuscitating deteriorating infants with sBPD.
Main Methods:
- This review synthesizes current knowledge on sBPD phenotypes, care phases, and exacerbation triggers.
- It examines the unique aspects of resuscitation for premature infants with sBPD.
- A framework for sBPD resuscitation, including prevention, assessment, and post-resuscitative care, is proposed.
Main Results:
- sBPD is characterized by diverse phenotypes and progresses through identifiable phases.
- Acute decompensation in sBPD can be triggered by various factors, necessitating specific management.
- Effective resuscitation requires a tailored approach distinct from general neonatal and pediatric practices.
Conclusions:
- Comprehensive understanding of sBPD phenotypes and phases is crucial for early identification of cardiopulmonary compromise.
- Targeted therapeutic interventions during acute episodes improve outcomes.
- A structured framework for sBPD resuscitation enhances patient care and management of deteriorating infants.
Abstract:
Severe bronchopulmonary dysplasia (sBPD) requiring invasive mechanical ventilation is a heterogeneous disease process that contributes to morbidity and mortality in infants. As the most common lung disease of prematurity, sBPD has a multitude of overlapping cardiac, airway, pulmonary vascular, and infectious phenotypic presentations that progress through four different phases of care. Premature infants with sBPD are at a high risk of acute decompensation and subsequent cardiopulmonary arrest. A comprehensive determination of the complex phenotypes that contribute to the clinical presentation will help clinicians decipher the phase of care, identify cardiopulmonary compromise earlier and guide targeted therapeutic intervention during acute episodes of deterioration. The approach to resuscitation of premature infants with sBPD undergoing an acute decompensation differs from general neonatal and pediatric resuscitation practices. This review summarizes the phenotypes of sBPD, the phases of care, the common triggers of acute exacerbations, and the principles of resuscitation of a deteriorating infant with sBPD. We offer a framework for sBPD resuscitation with a focus on prevention, assessment, and post-resuscitative care.
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