When you hear the words Chronic Lung Disease, most people think older
people walking around with nasal canulas dragging oxygen tanks with
them. Very few people would ever imagine a baby with Chronic Lung
Disease. So you could imagine how heart broken I was when Liam was
diagnosed with CLD. Come to find out Chronic Lung Disease is just
another way of saying long term respitory problems. And although its
used mostly for premature babies and elderly, others can get it too.It
is also known as bronchopulmonary dysplasia (BPD).
What causes chronic lung disease?
CLD results from lung injury
to newborns who must use a mechanical ventilator and extra oxygen for
breathing. The lungs of premature babies are fragile and are easily
damaged. With injury, the tissues inside the lungs become inflamed and
can break down causing scarring. This scarring can result in difficulty
breathing and increased oxygen needs. Some of the causes of lung injury
include the following:
- prematurity - the lungs, especially the air sacs, are not fully developed
- low amounts of surfactant (a substance in the lungs that helps keep the tiny air sacs open)
- oxygen use (high concentrations of oxygen can damage the cells of the lungs)
- mechanical
ventilation - the pressure of air from breathing machines, suctioning
of the airways, use of an endotracheal tube (ET tube - a tube placed in
the trachea and connected to a breathing machine)
Who is affected by chronic lung disease?
Chronic
lung disease can develop in premature babies who have had mechanical
ventilation (breathing machine). Risk factors for developing CLD
include:
- birth at less than 30 weeks gestation
- birth weight less than 1,000 (less than 2 pounds) to 1,500 grams (3 pounds 5 ounces)
- hyaline
membrane disease - lung disease of prematurity due to lack of
surfactant that does not show the usual improvement by the third or
fourth day.
- pulmonary interstitial emphysema (PIE) - a problem
in which air leaks out of the airways into the spaces between the small
air sacs of the lungs.
- patent ductus arteriosus (PDA) - a
connection between the blood vessels of the heart and lungs that does
not close as it should after birth.
- premature Caucasian, male babies are at greater risk for developing BPD
- maternal womb infection (chorioamnionitis)
- a family history of asthma
- breathing problems at birth
- develop an infection during or shortly after birth
What are the symptoms of chronic lung disease?
The
following are the most common symptoms of CLD. However, each baby may
experience different symptoms of the condition. Symptoms may include:
- respiratory distress (rapid breathing, flaring of the nostrils, grunting, chest retractions)
- continued need for mechanical ventilation or oxygen after a premature baby reaches 36 weeks gestation
Symptoms of CLD may resemble other conditions or medical problems. Always consult your baby's physician for a diagnosis.
How is chronic lung disease diagnosed?
Because
CLD is a chronic disease and appears gradually, physicians must look at
several factors. It is often diagnosed when a premature baby with
respiratory problems continues to need additional oxygen after
reaching 28 days old. Chest x-rays compared with previous x-rays may
show changes in the appearance of the lungs. The x-ray of lungs with CLD
often have a bubbly, sponge-like appearance. X-rays are diagnostic
tests which use invisible electromagnetic energy beams to produce images
of internal tissues, bones, and organs onto film.
Blood tests
(test used to determine if enough oxygen is in the blood) and an
echocardiography (test that use sound waves to create images of the
heart to rule out defects) are also used to confirm causes of
bronchopulmonary dysplasia.
Treatment of chronic lung disease:
Specific treatment for CLD will be determined by your baby's physician based on:
- your baby's gestational age, overall health, and medical history
- extent of the disease
- your baby's tolerance for specific medications, procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
Treatment of CLD may include:
- extra
oxygen (to make up for the decreased breathing ability of the damaged
lungs) and a pulse oximetry to measure how much oxygen is in the blood
- mechanical ventilation with gradual weaning as the baby's lungs grow and can do more of the work of breathing
- surfactant replacement
- medications such as:
- bronchodilators (to help open the airways)
- steroids (to help reduce inflammation)
- diuretics (to help reduce excess fluid in the lungs)
- antibiotics (to fight an infection)
- intravenous
fluids and nutrition (to help the baby and the lungs grow). It is
important to monitor the fluid intake, because excess fluids can build
up in the lungs and worsen the infant's breathing ability.
- radiant warmers or incubators to keep the infant warm and decrease the risks of developing an infection
- nutrition (to help the baby and the lungs grow)
- immunization against lung infection by respiratory syncytial virus (RSV) and influenza
CLD
can be a long-term condition. Some babies with CLD require mechanical
ventilators for several months. Some babies will continue to require
oxygen when they go home from the hospital, but most can be weaned from
oxygen by the end of their first year. Babies with CLD may be at
increased risk for respiratory infection and may have to be
re-hospitalized
(Information here was taken from
http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/respire/cld.html and is for educational purposes. Always seek medical attention and advice when it comes to your health)
