Neonatology
Chronic Lung Disease (CLD)
Ordinarily, fetal lungs are not exposed to air
until term. If an infant is delivered prematurely,
the lungs will be needed to support life. Immature
lungs are vulnerable to inflammation and injury
from oxygen and expansion of the airways with
breathing. Use of a ventilator is often necessary
to treat hyaline
membrane disease (HMD). Although ventilator
settings are adjusted frequently to provide only
the minimum support needed to assist the lungs,
some unavoidable inflammation and scarring of
the lung tissue may occur. This injury may take
time to resolve, and is referred to as chronic
lung disease (CLD).
In general, earlier gestation infants and those
requiring longer periods of ventilator
support are more susceptible to CLD. The onset
of CLD may result in a need for continued ventilator
or oxygen support once HMD has resolved.
Treatment
CLD may be treated with diuretics
and, on occasion, steroids, to reduce water content
and inflammation in the lung tissue. Once an infant
is weaned from the ventilator, continued support
with CPAP or oxygen may be necessary because of
CLD.
Most premature infants will not need extra oxygen
by the time they are discharged home. However,
oxygen at home may be arranged easily for those
who require it. In these cases, home oxygen usually
does not need to be continued for more than a
few months.
As an infant with CLD grows, all new lung tissue
that forms is normal, and lung function usually
improves steadily. For the first year, an infant
with CLD may be more susceptible than other infants
to respiratory infections, so common sense precautions
should be taken to protect the infant from others
who may be sick.
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