[Pulmonary causes of hypoxia in premature infants and its therapeutic possibilities]

Pulmonary illness as a cause of postnatal hypoxia in premature infants frequently calls for an extended clinical course. Concealed behind the common symptoms--cyanosis, tachypnoea, expiratory grunting, thoracic and/or epigastric retraction and nasal flaring--is a broad spectrum of respiratory disorders. Lack of surfactant plays the most important role in premature infants, although meconium aspiration, persistent fetal circulation, the post asphyxia syndrome, transient tachypnoea of the newborn and pneumonias can also be the underlying cause. 1.

a. Avoid preterm delivery-b. Induce maturation of the fetal lungs (antenatal maternal corticosteroid administration). 2. Treatment of the cause: Endotracheal surfactant replacement therapy. 3. Symptomatic treatment: Respiratory support, from the simple method of giving oxygen over a mask to artificial ventilation. Immature lung tissue can be destracted as a complication of artificial ventilation. Here, the cause for the pulmonary hypoxia is iatrogenic. The resultant clinical picture of bronchopulmonary dysplasia (BPD) can then determine progress of the child for weeks or months to follow. The most important measure in the prevention of BPD are, in addition to the prophylaxis and treatment of the causes of respiratory disorders in preterm infants, the skilled resuscitation in the labor ward, and most important of all, the gentle handling and loving care for the tiny premature baby.