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Bronchial hypersecretion in preterm neonates

Y C Wong, C S Beardsmore, J H Meek

Archives of Disease in Childhood

|February 1, 1982

Summary

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Mechanical ventilation in preterm infants can cause excessive airway secretions, leading to breathing difficulties and chronic lung disease. Equipment contamination may be a contributing factor.

Area of Science:

Neonatal Intensive Care
Pediatric Respiratory Medicine
Critical Care

Background:

Preterm infants undergoing intensive care are susceptible to respiratory complications.
Excessive tracheobronchial secretions pose a significant challenge in managing mechanical ventilation.

Purpose of the Study:

To investigate the incidence, clinical course, and potential etiological factors of excessive tracheobronchial secretions in preterm infants.
To assess the long-term respiratory outcomes in infants experiencing this complication.

Main Methods:

Retrospective review of 11 preterm infants (700-1560 g birthweight) with excessive secretions during mechanical ventilation over 18 months.
Clinical assessment, respiratory parameters (PCO2), and follow-up evaluations for airway obstruction and lung function.

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Main Results:

Infants developed copious, viscous secretions around day 5 of mechanical ventilation, causing recurrent segmental collapse, hypoxia, and hypercapnia.
While no deaths occurred, morbidity was high, with 4 infants experiencing airway narrowing and increased incidence of chronic lung disease.
Contamination of mechanical ventilation equipment with detergent and glutaraldehyde was identified as a potential contributing factor.

Conclusions:

Excessive tracheobronchial secretions in ventilated preterm infants are associated with significant respiratory morbidity and long-term airway issues.
Contamination of respiratory equipment is a plausible etiological factor requiring further investigation.
This condition highlights the need for vigilant monitoring and potential interventions to prevent complications in vulnerable infants.