Late pulmonary sequelae of bronchopulmonary dysplasia

Article Abstract:

With the advent of new life-saving technology, premature babies are more likely than ever to survive. However, the lungs of a premature baby are often not up to the task of life in the outside world, and even if the baby survives due to mechanical respiration, the chances of chronic lung disease are high. The use of oxygen and mechanical respiration can result in a lung syndrome called bronchopulmonary dysplasia. This condition has become the number one chronic lung disease of infants in the US, and about 7,000 new cases occur each year. About 40 percent of the victims of pulmonary dysplasia die, and the remainder have persistent respiratory problems. Although research has followed such patients into childhood, there is little evidence available to determine how much of a deficit remains in adolescence or adulthood. For this reason, 25 young adults born between 1964 and 1973 who had bronchopulmonary dysplasia in infancy were tested for respiratory function. Six of the subjects had symptoms of respiratory difficulty of which four had moderate or severe symptoms. Respiratory problems among the remaining subjects were asymptomatic, and were revealed only upon testing. (However, the performance of the patients during exercise was not observed in this study.) Seventeen of 25 subjects had signs of airway obstruction as indicated by reductions in the flow velocity on expiration and decreases in the forced expiratory volume. Also common was hyperinflation, which is when the residual air volume of the lungs is larger in relation to the total lung capacity. The results of this study indicate that the effects of bronchopulmonary dysplasia in infancy persist into adulthood. It is not clear, however, to what degree these functional abnormalities actually affect the health of the subjects. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infants (Newborn), Newborn infants, Bronchopulmonary dysplasia

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Echocardiography: first of two parts

Article Abstract:

Areview is provided of the methods and effectiveness of a group of techniques called echocardiography. These noninvasive techniques are used in diagnosing and treating heart disease. The noninvasive approach allows clinicians to observe cardiac contractions and blood flow in the heart and great vessels (the vessels leading to and from the heart), and to calculate pressure gradients within the organ. In all methods, sound is transmitted through the heart and reflected by the surfaces it encounters. The reflected sound (echo) is detected by a transducer and the time between sound transmission and reception is converted into a distance measurement. Sampling at different depths allows construction of a 'picture' of internal structures in correct anatomical orientation. The motion (M mode) of structures is recorded by repeated sampling of one direction of the sound beam. A contrast agent that reflects sound can be injected. Doppler echocardiography registers frequency shifts when the sound waves reflect off moving materials, such as blood. Echocardiography is especially useful for diagnosing disease of the heart valves (the structures that open and shut to regulate forward flow and backflow of blood). The advantages and limitations of the method with regard to specific diagnoses are evaluated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cardiovascular diseases, Diagnosis, Echocardiography

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The influence of the wider use of surfactant therapy on neonatal mortality among blacks and whites

Article Abstract:

Premature white babies appear to have benefitted more from surfactant therapy than premature black babies. Surfactant therapy was approved in 1990 to treat very-low-birth-weight babies with respiratory distress syndrome. After 1990, the mortality rate among these babies dropped 17%. However, the mortality rate among black babies remained the same while the rate in white babies dropped 41%. Black babies were just as likely to receive surfactant as white babies but they may have less need for it, since their lungs mature faster.

Patient outcomes, Mortality, Respiratory distress syndrome, Lung surfactant, Synthetic, Synthetic lung surfactants

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