慢性肺病的新进展.doc

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慢性肺病的新进展

Authors: James M Adams, Jr, MD Ann R Stark, MD Section Editor: Richard Martin, MD Deputy Editor: Melanie S Kim, MD Disclosures:James M Adams, Jr, MD?Nothing to disclose.?Ann R Stark, MD?Nothing to disclose.?Richard Martin, MDConsultant/Advisory Boards: Discovery Labs [surfactant therapy (lucinactant)].?Melanie S Kim, MD?Nothing to disclose.? Contributor disclosures are reviewed for conflicts of interest by the editorial group. When found, these are addressed by vetting through a multi-level review process, and through requirements for references to be provided to support the content. Appropriately referenced content is required of all authors and must conform to UpToDate standards of evidence. Conflict of interest policy All topics are updated as new evidence becomes available and our?peer review process?is complete. Literature review current through:?Oct 2015.?|?This topic last updated:?Aug 03, 2015. INTRODUCTION?—?Bronchopulmonary dysplasia (BPD), also known as neonatal chronic lung disease (CLD), is an important cause of respiratory morbidity in preterm newborns. Day-to-day care is mostly directed towards improving symptoms, with many common interventions having little impact on long-term outcome. Most patients with BPD gradually improve as healing occurs and lung growth continues, but the time required for improvement varies widely. Management is also directed at minimizing further injury, providing an optimal environment to support growth and recovery, and detecting complications associated with BPD. The management of BPD is reviewed here. Pathogenesis and clinical features, prognosis, and potential strategies to prevent BPD are discussed separately. (See?Pathogenesis and clinical features of bronchopulmonary dysplasia?and?Outcome of infants with bronchopulmonary dysplasia?and?Prevention of bronchopulmonary dysplasia.) RESPIRATORY SUPPORT?—?Respiratory care is supportive and should minimize additional injury. Mechanical ventilation?—?In patients with establishe

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