neo resp brodsky

Question 1

what is the effect of corticosteroid on the lung antenatally and postnatally?

Answer 1

Use of corticosteroids has pleotropic effects on the fetus and newborn and the lung is a target of
corticosteroid action. Antenatal corticosteroids help to 1. mature the fetal lung, 2. primarily by decreasing
the amount of mesenchymal tissue and 3. increasing the potential airspace volume. These anatomic
changes result in an 4. arrest in alveolar (saccular) septation.
5. Similarly, postnatal corticosteroids arrest
alveolar septation and microvascular development.

Question 2

how to define bpd?

Answer 2

BPD has been defined as oxygen need at 36 weeks’ postmenstrual age (PMA). A 2000 National Institutes of Health workshop recommended a graded diagnosis for BPD to better describe
the clinical status of affected infants; this categorization is defined as follows:
1) Mild BPD: Treatment with oxygen for at least 28 days PLUS breathing room air at 36 weeks’
PMA or discharge
2) Moderate BPD: Treatment with oxygen for at least 28 days PLUS need for <30% oxygen at
36 weeks’ PMA or discharge
3) Severe BPD: Treatment with oxygen for at least 28 days PLUS need for ≥ 30% oxygen
and/or positive pressure (ventilation or continuous positive airway pressure) at 36 weeks’
PMA
BPD can also be defined by the infant’s ventilator and/or oxygen need and oxygen saturation. An
infant at 35 to 37 weeks’ PMA who is receiving mechanical ventilation, continuous positive airway
pressure, or >30% oxygen with oxygen saturations < 96% has BPD. However, an infant who is
receiving <30% oxygen or >30% oxygen with saturations >96% and is able to wean to room air after
a gradual decrease in oxygen with oxygen saturations >90% for 30 minutes, does not have BPD