Neonatology Questions and Controversies: The Newborn Lung

4th Edition - August 7, 2023

Editors: Richard A. Polin, Eduardo Bancalari, Martin Keszler, Peter G Davis

Language: English

Paperback ISBN:

9 7 8 - 0 - 3 2 3 - 8 7 8 7 4 - 6

eBook ISBN:

9 7 8 - 0 - 3 2 3 - 8 7 9 3 5 - 4

Dr. Richard Polin’s Neonatology Questions and Controversies series highlights the toughest challenges facing physicians and care providers in clinical practice, offering trust… Read more

Neonatology Questions and Controversies: The Newborn Lung

Purchase options

Info / Buy

LIMITED OFFER

Save 50% on book bundles

Immediately download your ebook while waiting for your print delivery. No promo code is needed.

Institutional subscription on ScienceDirect

Request a sales quote

Dr. Richard Polin’s Neonatology Questions and Controversies series highlights the toughest challenges facing physicians and care providers in clinical practice, offering trustworthy guidance on up-to-date diagnostic and treatment options in the field. In each volume, renowned experts address the clinical problems of greatest concern to today’s practitioners, helping you handle difficult practice issues and provide optimal, evidence-based care to every patient.

Cover image
Title page
Table of Contents
Other Volumes in the Neonatology Questions and Controversies Series
Copyright
Contributors
Series Foreword
Preface
List of Illustrations
List of Tables
1. Perinatal events and their influence on lung development and injury
Overview of lung development and perinatal events
Lung development: The substrate for adverse events
Lung maturation
Antenatal infection/inflammation
Intrauterine growth restriction/small for gestational age (SGA)
Environmental factors and lung disease
Summary: The complexities
References
2. Respiratory and cardiovascular support in the delivery room
Understanding the transition to newborn life
Anticipating and preparing for neonatal resuscitation
Rapid assessment after birth
Initial steps for nonvigorous and preterm newborns
Effective ventilation: The key!
Chest compressions during resuscitation in the delivery room
Medications during resuscitation in the delivery room
Discontinuing resuscitative efforts
References
3. Vascular development and pulmonary hypertension
Development of the fetal pulmonary circulation
Physiology of the fetal pulmonary circulation
Mediators of fetal pulmonary vascular development
Transitional circulation and postnatal pulmonary vascular development
Features of abnormal pulmonary vascular development
Factors that disrupt fetal pulmonary vascular development
Clinical implications and controversies
Pulmonary hypertension treatment: Concepts and controversies
Conclusions
References
4. Airway microbiome and lung injury
Introduction
Newborn lung microbiome
Role of Ureaplasma species in intrauterine infection and neonatal lung injury
Developmental deficiencies in innate immunity contribute to susceptibility to Ureaplasma infection and dysregulated inflammation
Can bronchopulmonary dysplasia be prevented by Ureaplasma eradication?
Summary
References
5. Ventilator-associated pneumonia
Introduction
Definition
Epidemiology
Pathogenesis
Treatment
Prevention
Outcomes
Future research directions
Conclusion
References
6. Noninvasive respiratory support for preterm infants: An alternative to mechanical ventilation
Introduction
Why do preterm infants experience respiratory failure and how can noninvasive respiratory support help?
A brief history of neonatal mechanical ventilation and noninvasive respiratory support
Nasal continuous positive airway pressure
Nasal intermittent positive-pressure ventilation
Summary and recommendations
Noninvasive high-frequency ventilation
Nasal high flow
Future directions
Acknowledgments
References
7. Newer strategies for surfactant delivery
Introduction
Techniques of surfactant administration without an endotracheal tube
Surfactant administration via brief tracheal catheterization
Surfactant administration via brief tracheal catheterization—scientific and practical considerations
Surfactant administration via brief tracheal catheterization—recommendations
Surfactant administration via brief tracheal catheterization—future research directions
References
8. Respiratory control and oxygen instability in premature infants
Introduction
Biological challenges in characterizing neonatal respiratory control
Central respiratory control
Central and peripheral chemosensitivity
Contribution from inflammatory mechanisms
Clinical challenges in defining neonatal apnea
Mechanisms of oxygenation instability
Association between intermittent hypoxemia, bradycardia, and outcomes
Mechanistic insights into morbidity
Controversies in therapy
References
9. Pulmonary-cardiovascular interaction
Introduction
Cardiorespiratory interactions at birth
The physiology of cardiovascular and respiratory interaction
Effect of the respiratory system on the cardiovascular system
Effect of the cardiovascular system on the respiratory system
Interaction during early transition and potential clinical implications
Interaction after transition and potential clinical implications
Conclusions
References
10. Ventilator strategies to reduce lung injury and duration of mechanical ventilation
Introduction
Ventilator-associated lung injury
How can we reduce VALI?
Delivery room stabilization
Noninvasive respiratory support
Strategies of mechanical ventilation
Basic modes of synchronized ventilation
Synchronized intermittent mandatory ventilation
Assist control
Pressure support ventilation
Choice of assisted ventilation modes
Volume-targeted ventilation
Importance of the open lung strategy
High-frequency ventilation
Evidence-based approach to mechanical ventilation
Conflict of interest statement
References
11. Prenatal and postnatal steroids and pulmonary outcomes
Antenatal corticosteroids
Postnatal steroids
Summary and future directions
References
12. Cell-based therapy for neonatal lung diseases
Introduction
Endogenous lung stem cells
Cell therapies for neonatal lung diseases
Conclusion
References
13. Definitions and diagnostic criteria of bronchopulmonary dysplasia: Clinical and research implications
Abbreviations
Clinical presentation of bronchopulmonary dysplasia
Bronchopulmonary dysplasia diagnosis
Existing diagnostic criteria for bronchopulmonary dysplasia
Competing outcomes
Defining the populations at risk for bronchopulmonary dysplasia
Prognosis for long-term pulmonary impairment
Implications for future research
Conclusion
References
14. A physiology-based approach to the respiratory care of children with severe bronchopulmonary dysplasia
Introduction
Definitions and scope of severe bronchopulmonary dysplasia
Pathogenesis of severe bronchopulmonary dysplasia
Pathophysiology of severe bronchopulmonary dysplasia
Evaluation and treatment of severe bronchopulmonary dysplasia
Long-term outcomes
Acknowledgments
References
15. Long-term pulmonary outcome of preterm infants
Controversies
What are the long-term pulmonary outcomes for late preterm infants?
What are the long-term pulmonary outcomes for very preterm infants, and what is the effect of having BPD on these outcomes?
Are we improving expiratory airflow in survivors born extremely preterm over time in the post-surfactant era?
What are the effects of cigarette smoking?
Is there a role for caffeine in the newborn period?
What further research is required?
Summary
References
16. Perinatal nutrition and the lung
Introduction
Prenatal nutrition and lung development
Nutritional interventions for primary prevention of preterm birth
Maternal undernutrition
Maternal over nutrition
Maternal intake of micronutrients
Postnatal nutrition and respiratory outcomes
Preterm infant nutrition
Undernutrition, growth failure, and pulmonary consequences
Adequate nutrition to support lung growth and function
Conclusion
References
17. Caffeine—respiratory stimulant or magic bullet?
Introduction
Caffeine is the respiratory stimulant of choice for preterm infants
Caffeine for apnea of prematurity trial
Remaining uncertainties about neonatal caffeine therapy
Is caffeine a magic bullet?
References
18. The neonatal lung: Lung imaging using ultrasound and electric impedance tomography
Abbreviations
Introduction
Lung ultrasound
Electrical impedance tomography
Conclusions and future directions
References
19. Genetic disorders of alveolar formation and homeostasis
Genetic disorders of lung formation
Mutations in genes in pulmonary mesenchyme
Mutations in genes expressed in the embryonic epithelium (NKX2-1/TTF-1)
Mutations in SOX2 and SOX9 are associated with multiple congenital malformations
Critical role of pulmonary surfactant after birth
Diffuse pulmonary disease caused by surfactant dysfunction
Genetic disorders of surfactant homeostasis
Inherited disorders of surfactant homeostasis: SP-B, SP-C, and ABCA3
Surfactant protein B
Surfactant protein C
ABCA3: Disorder of lipid transport and lamellar body formation
Clinical perspectives
Recommended for review
References
20. Fetal intervention in congenital malformations of the respiratory system
Introduction
Congenital diaphragmatic hernia
Congenital lung masses or congenital pulmonary malformations
Conclusions
References
Index