Prematurity and CLD
title: Prematurity and Neonatal Chronic Lung Disease tags: #FFICM notebook: ð-FFICM type: anki
source: [[acute-respiratory-failure-in-children]]
category: [[paediatrics]]
Lungs develop up until late childhood.
There are five stages of lung development:
- embryonic
- pseudoglandular
- canalicular
- saccular
- alveolar
I Don't think that needs flashcards.
It's by 32 weeks that the intrinsic surfactant starts being made. You can give mothers corticosteroids if they are having a premature birth to stimulate surfactant production.
| Flashcard | type:basic |
|---|---|
| In embryology, when does the developing child start producing surfactant? | After 32 weeks |
So premature neonates are going to have smaller lungs
Prematurity Definitions
- Newborn is term if > 37 weeks
- Prematurity if born < 37 weeks
- Extremely low birth weight is < 1kg
- Very low birth weight is < 1.5kg
- Low birth weight is less than 2.5kg
- Small for gestational age is less than 5th percentile of weight for gestational age
| Flashcard | type:basic |
|---|---|
| How small do you need to be small for gestational age? | Less than 5th percentile of weight expected at gestational age |
Chronic Neonatal Lung Disease
Defn:
Oxygen requirement 28 days post delivery or:
Oxygen requirement at 36 weeks gestational delivery
Pathology
- Bronchopulmonary dysplasia
-
Hyaline Membrane Disease
-
Alveolar Septal Fibrosis
- Alternating collapse and hyperinflation of acini
| Flashcard | type:basic |
|---|---|
| What's the pathophysiology behind premature neonates having bad lungs? | It's like COPD they've got a mix of fibrosis, collapse and hyperinflation of acini |
Comorbidity
CNLD is going to increase your risk of being admitted to PICU with respiratory failure
Apnoea
Premature infants go apnoeac. As a central brain thing rather than a lung thing. Any illness will increase their risk of apnoea too.
So they may need ventilated.
A rare cause of apneoa as a congenital thing would be "central hypoventilation due to PHOX2B mutation"