Respiratory - Chronic Lung Disease of Prematurity

Question 1

How is chronic lung disease of prematurity also known?

Answer 1

Bronchopulmonary dysplasia

Question 2

Who is affected by chronic lung disease of prematurity?

Answer 2

Premature babies, typically born before 28 weeks gestation

Question 3

How is chronic lung disease of prematurity diagnosed?

Answer 3

CXR changes
When infant requires oxygen therapy before 36 weeks gestation

Question 4

What are the features of CLDP?

Answer 4

• Low oxygen saturations
• Increased work of breathing
• Poor feeding and weight gain
• Crackles and wheezes on chest auscultation
• Increased susceptibility to infection

Question 5

How is CLDP prevented?

Answer 5

During pregnancy
- Corticosteroids e.g. betamethasone, to mothers that show signs of premature labour, to speed up development of fetal lungs before birth

Once born
- CPAP rather than intubation
- Caffeine to stimulate respiratory effort
- Not over-oxygenating with supplementary oxygen

Question 6

How is CLDP managed?

Answer 6

Sleep study
To assess oxygen saturations

Low dose oxygen at home via nasal cannula

RSV protection
Monthly injections of palivizumab
Very expensive, reserved for babies that meet criteria