Role of Systemic Inflammatory Indices in the Prediction of Moderate to Severe Bronchopulmonary Dysplasia in Preterm Infants

Introduction: The role of systemic inflammatory indices in the diagnosis of bronchopulmonary dysplasia (BPD) is unknown. The aim of the study was to determine the possible clinical utility of systemic inflammatory indices in the prediction of moderate to severe BPD. Methods: Premature infants<32 weeks of gestational age were included in the study. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), and systemic inflammation response index (SIRI) were calculated at birth and at the time of diagnosis of BPD (at 36th weeks of postmenstrual age). The patients were divided into two groups as no or mild BPD and moderate or severe BPD. Results: A total of 1146 infants were included in the study, 957 in Group 1 and 189 in Group 2. The SIRI value was significantly higher in moderate or severe BPD both at birth and at the 36th week of postmenstrual age (p<0.001 and p<0.001, respectively). The AUC value of SIRI was 0.809 and the cut-off value was>0.98 in the predictivity of BPD at birth. The AUC value of SIRI was 0.842 and the cut-off value was>1.33 for the diagnosis of BPD at 36th week of postmenstrual age. After multiple logistic regression analysis, SIRI was shown to be a significant parameter for the diagnosis of BPD (OR 2.847, 95% CI 1.557–4.875). Conclusions: SIRI may be a useful biomarker for predicting moderate to severe BPD and a marker of clinical importance in the follow-up of infants with BPD. (AU)

SIRT3 improves alveolar epithelial cell damage caused by bronchopulmonary dysplasia through deacetylation of FOXO1

Background: Bronchopulmonary dysplasia (BPD) is a serious and long-term lung condition commonly observed in premature babies. Sirtuin 3 (SIRT3) has been reported to reduce pulmonary injury and pulmonary fibrosis. Objective: The present study investigated the specific role of SIRT3 in BPD by establishing hyperoxia-induced BPD rat and cell models. Hematoxylin and eosin staining was used to observe pathological changes in lung tissues. Materials and methods: The expression levels of SIRT3 and forkhead box protein O1 (FOXO1), as well as its acetylation levels, were detected in hyperoxia-induced lung tissues and cells by Western blot analysis and reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Levels of reactive oxygen species, superoxide dismutase, and malondialdehyde were assessed by using biochemical kits. Following SIRT3 overexpression, the levels of inflammatory cytokines were assessed by RT-qPCR. Apoptosis was determined by terminal deoxynucleotidyl transferase dUTP nickend labeling (TUNEL) and Western blot analysis. Upon FOXO1 knockout, cell inflammation, oxidative stress and apoptosis were evaluated again. Results: Compared to the control group, the SIRT3 and FOXO1 expression levels were decreased and the FOXO1 acetylation levels were increased in hyperoxia-induced lung tissues and cells. In addition, SIRT3 reduced hyperoxia-induced inflammation, oxidative stress, and apoptosis in A549 cells, and inhibited FOXO1 acetylation to activate FOXO1. However, FOXO1 knockdown reversed the effects of SIRT3 overexpression in hyperoxia-induced A549 cells. Conclusion: SIRT3 relieved alveolar epithelial cell damage caused by BPD via deacetylation of FOXO1, suggesting that SIRT3 could be a therapeutic target in BPD (AU)

Knockdown of EDA2R alleviates hyperoxia-induced lung epithelial cell injury by inhibiting NF-KB pathway

Background: Long-term hyperoxia impairs growth of the lungs and contributes to develop-ment of bronchopulmonary dysplasia. Ectodysplasin A (EDA) binds to ectodysplasin A2 recep-tor (EDA2R) and is essential for normal prenatal development. The functioning of EDA2R in bronchopulmonary dysplasia is investigated in this study.Methods: Murine lung epithelial cells (MLE-12) were exposed to hyperoxia to induce cell injury. Cell viability and apoptosis were detected, respectively, by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide) assay and flow cytometry. Inflammation and oxidative stress were evaluated by enzyme-linked immunosorbent serologic assay.Results: Hyperoxia decreased cell viability and promoted cell apoptosis of MLE-12. EDA2R was elevated in hyperoxia-induced MLE-12. Silencing of EDA2R enhanced cell viability and reduced cell apoptosis of hyperoxia-induced MLE-12. Hyperoxia-induced up-regulation of tumor necro-sis factor alpha (TNF-α), Interleukin (IL)-1β, and IL-18 as well as MLE-12 was suppressed by knockdown of EDA2R. Inhibition of EDA2R down-regulated the level of malondialdehyde (MDA), up-regulated superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH) in hyperoxia-induced MLE-12. Interference of EDA2R attenuated hyperoxia-induced increase in p-p65 in M LE-12.Conclusion: Knockdown of EDA2R exerted anti-inflammatory and antioxidant effects against hyperoxia-induced injury in lung epithelial cells through inhibition of nuclear factor kappa B (NF-κB) pathway (AU)

Epidemiología y factores de riesgo asociados a displasia broncopulmonar en prematuros menores de 32 semanas de edad gestacional / Epidemiology and risk factors for bronchopulmonary dysplasia in preterm infants born at or less than 32 weeks of gestation

Objetivos: Describir los factores de riesgo de displasia broncopulmonar en las primeras semanas de vida en grandes prematuros. Material y métodos: Estudio observacional de cohortes, retrospectivo, en recién nacidos ≤ 32 semanas y ≤ 1.500 g. Se realizó un análisis multivariante de regresión logística para identificar factores de riesgo independientes en las primeras semanas de vida. Resultados: Se incluyeron 202 recién nacidos con una edad gestacional media de 29,5 ± 2,1 semanas. El 61,4% de los pacientes no recibió ventilación mecánica invasiva. El 28,7% fue diagnosticado de displasia broncopulmonar y el 10,4% de displasia broncopulmonar moderada-grave. La edad gestacional (p < 0,001; OR = 0,44 [IC 95% = 0,30-0,65]), la ventilación mecánica en el día 1 (p = 0,001; OR = 8,13 [IC 95% = 2,41-27,42]), la sepsis nosocomial (p < 0,001; OR = 9,51 [IC 95% = 2,99-30,28]) y la FiO2 en el día 14 (p < 0,001; OR = 1,39 [IC 95% = 1,16-1,66]) fueron los factores de riesgo independientes de displasia broncopulmonar. La ventilación mecánica el día 1 (p = 0,008; OR = 5,39 [IC 95% = 1,54-18,89]) y 3 de vida (p = 0,001; OR = 9,99 [IC 95% = 2,47-40,44]) y la sepsis nosocomial (p = 0,001; OR = 9,87 [IC 95% = 2,58-37,80]) se asociaron al desarrollo de displasia broncopulmonar moderada-grave. Conclusiones: La edad gestacional, la ventilación mecánica en los primeros días de vida y la sepsis nosocomial son factores de riesgo precoces de displasia broncopulmonar. El análisis de datos clínicos sencillos y objetivos nos permite seleccionar a un grupo de pacientes con alto riesgo de desarrollar displasia broncopulmonar, en el que podría estar justificado actuar de forma más agresiva y nos muestra áreas de mejora para prevenir su desarrollo o disminuir su gravedad. (AU)

Objectives: To describe risk factors of bronchopulmonary dysplasia in very preterm infants in the first weeks of life. Material and methods: Retrospective cohort study of preterm infants ≤ 32 weeks of gestational age and birth weight ≤ 1500 g. A multivariate logistic regression analysis was performed to identify independent risk factors for bronchopulmonary dysplasia in the first weeks of life. Results: A total of 202 newborns were included in the study (mean gestational age 29.5 ± 2.1 weeks), 61.4% never received invasive mechanical ventilation. The incidence of bronchopulmonary dysplasia was 28.7%, and 10.4% of the patients were diagnosed with moderate–severe bronchopulmonary dysplasia. Bronchopulmonary dysplasia was independently associated with gestational age at birth (p < 0.001; OR = 0.44 [95% CI = 0.30–0.65]), the need for mechanical ventilation on the first day of life (p = 0.001; OR = 8.13 [95% CI = 2.41–27.42]), nosocomial sepsis (p < 0.001; OR = 9.51 [95% CI = 2.99–30.28]) and FiO2 on day 14 (p < 0.001; OR = 1.39 [95% CI = 1.16–1.66]). Receiving mechanical ventilation at the first day of life (p = 0.008; OR = 5.39 [95% CI = 1.54–18.89]) and at the third day of life (p = 0.001; OR = 9.99 [95% CI = 2.47–40.44]) and nosocomial sepsis (p = 0.001; OR = 9.87 [95% CI = 2.58–37.80]) were independent risk factors for moderate–severe bronchopulmonary dysplasia. Conclusions: Gestational age at birth, mechanical ventilation in the first days of life and nosocomial sepsis are early risk factors for bronchopulmonary dysplasia. The analysis of simple and objective clinical data, allows us to select a group of patients at high risk of bronchopulmonary dysplasia in whom it could be justified to act more aggressively, and shows areas for improvement to prevent its development or reduce its severity. (AU)

SEMA3A protects against hyperoxia-induced lung injury in a bronchopulmonary dysplasia model of newborn rat by inhibiting ERK pathway

Background Hyperoxia induces lung injury through lung inflammation in premature infants, leading to bronchopulmonary dysplasia (BPD). Semaphorin 3A (SEMA3A) participates in diverse biological processes, including cell migration, angiogenesis, and inflammation. The effect of SEMA3A on hyperoxic lung injury of neonatal rats with BPD was investigated in this study. Methods Neonatal rats with BPD were established through hyperoxia treatment. Hematoxylin-eosin staining was used to evaluate histopathological analysis in lung tissues. SEMA3A expression was assessed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blot assay. Adeno-associated virus (AAV)-mediated over-expression of SEMA3A (AAV-SEMA3A) was administrated into hyperoxia-induced rats, and apoptosis was evaluated by TUNEL staining. Levels of inflammatory cytokines were investigated by enzyme-linked-immunosorbent serologic assay (ELISA). Results Hyperoxia-induced histopathological changes in lung tissue reduced alveolar number and enhanced alveolar interval and alveolar volume. SEMA3A was downregulated in lung tissue of hyperoxia-induced rats. AAV-SEMA3A injection attenuated hyperoxia-induced cell apoptosis in lung tissues by increasing Bcl-2 and decreasing Bax and cleaved caspase-3. Moreover, the enhanced levels of Interleukin (IL)-1β, monocyte chemoattractant protein (MCP)-1, and tumor necrosis factor-α (TNF-α) in hyperoxia-induced rats were restored by AAV-SEMA3A injection by the downregulation of nuclear factor kappa B (NF-κB) phosphorylation. AAV-SEMA3A injection also ameliorated histopathological changes in lung tissues of hyperoxia-induced rats by increasing the number of radial alveolar count and decreasing the volume of mean linear intercept. Besides, the protein expression levels of extracellular signal-regulated kinase (ERK) and c-Jun N-terminal kinase (JNK) phosphorylation were reduced in hyperoxia-induced rats post-AAV-SEMA3A injection (AU)

Utilidad de la ecografía pulmonar para monitorizar la sobredistensión grave en paciente con displasia broncopulmonar grave / Lung overdistention monitorization by ultrasound in a patient with severe bronchopulmonary dysplasia

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Displasia broncopulmonar: importancia del ejercicio físico / Bronchopulmonary Dysplasia: The Importance Of Physical Exercise

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20 años en neumología pediátrica / 20 years in pediatric pneumonology

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Is Endocan a Novel Diagnostic Marker for the Severity of Bronchopulmonary Dysplasia in Very Low Birth Weight Infants? / ¿Es el endocan un nuevo marcador diagnóstico de la gravedad de la displasia broncopulmonar en lactantes con muy bajo peso al nacer?

Introduction: Endocan levels were found to be associated with severity and mortality of the respiratory system diseases. Objective: We aimed to figure out whether endocan was an important marker for the diagnosis, severity and follow-up of bronchopulmonary dysplasia (BPD). Materials and methods: Infants with moderate/severe BPD, and who required hydrocortisone treatment were included in the study group. Infants without BPD were allocated in the control group. Endocan levels were compared between the control group and the study group, and before and after the treatment in the study group. Results: A total of 148 infants, 74 infants in the control group and 74 infants in the BPD group, were included. The endocan level was higher in the BPD group than in the control group (P = .001). Endocan levels before treatment in the BPD group was found to be higher than endocan level after treatment (P = .021). Conclusion: Our study found that endocan levels increased in moderate/severe BPD. Serum endocan levels may be a safe and novel indicator for the follow-up of response to treatment and the prognosis of the severity of the disease

Introducción: Los niveles de endocan se han asociado con la mortalidad y la gravedad de enfermedades del aparato respiratorio. Objetivo: El objetivo fue averiguar si el endocan es un marcador útil para el diagnóstico, la gravedad y el seguimiento de la displasia broncopulmonar (DBP). Materiales y métodos: Se incluyeron en el estudio lactantes con DBP moderada/grave que requirieron tratamiento con hidrocortisona (grupo DBP). El grupo control lo constituyeron lactantes sin DBP. Los niveles de endocan se compararon entre el grupo control y el grupo de estudio y, en este último, tanto antes como después del tratamiento. Resultados: Se incluyeron un total de 148 lactantes; 74 en el grupo control y 74 en el grupo DBP. Los niveles de endocan fueron más elevados en el grupo DBP que en el grupo control (p = 0,001). Los niveles de endocan también resultaron superiores en el grupo DBP antes del tratamiento que después del mismo (p = 0,021). Conclusión: Nuestro estudio halló que los niveles de endocan se encuentran incrementados en la DBP moderada/grave. Los niveles séricos de endocan podrían utilizarse como un nuevo indicador seguro para el seguimiento de la respuesta al tratamiento y el pronóstico de gravedad de la enfermedad

Physical Activity Program Improves Functional Exercise Capacity and Flexibility in Extremely Preterm Children With Bronchopulmonary Dysplasia Aged 4-6 Years: A Randomized Controlled Trial / Mejora de la capacidad funcional al ejercicio y de la flexibilidad a través de un programa de actividad física en niños de entre 4 a 6 años prematuros extremos con displasia broncopulmonar: ensayo controlado aleatorizado

Introduction: Bronchopulmonary dysplasia (BPD) is the most common complication of extreme preterm delivery, and is associated with reduced exercise tolerance and exercise capacity. The aim of this study was to assess the effects of a physical activity programme on exercise tolerance, exercise capacity, flexibility, and lung function in prematurely born children with BPD. Methods: This was a randomized controlled trial. Preterm children with BPD (4-6 years) were randomized to intervention (IG) and control (CG) groups. The CG did not participate in any physical activity during the study period. The IG performed a 4-week exercise programme based on aerobic interval and resistance training. Outcomes were based on the 6-minute walk test (6MWT), incremental shuttle walk test (ISWT), modified sit and reach test (MSRT) and spirometry results. Results: Twenty individuals were recruited. In the IG (n = 10), statistical and clinical improvement was observed in the 6MWT (316.3 ± 31.4 m vs 376.2 ± 39.5m; P = .002). Significant improvements were also seen in the IG in the ISWT (248.0 ± 45. 2m vs 465.3 ± 58.2 m; P=.013), MSRT (14.5 ± 7.7 cm vs 22.8 ± 6.9 cm; P = .003), and FEV1 (102% ± 16% pred vs 104% ± 17% pred; P = .004). No significant differences between pre- and post-intervention were observed in the CG for all outcomes (n = 10). Conclusion: This 4-week programme resulted in statistical and clinical improvements in exercise tolerance, exercise capacity and flexibility in preterm children with BPD

Introducción: La displasia broncopulmonar (DBP) es una secuela frecuente entre los prematuros extremos, asociándose a una reducción en la tolerancia y en la capacidad al ejercicio. El objetivo de este estudio es evaluar los efectos de un programa de entrenamiento basado en la tolerancia y en la capacidad al ejercicio, la flexibilidad y la función pulmonar en niños prematuros con DBP. Métodos: El ensayo clínico se hizo con niños prematuros con DBP (de 4 a 6 años), aleatorizados en 2 grupos, control (GC) e intervención (GI). El GC no participó en ninguna actividad física durante el estudio. El GI realizó un programa interválico y de resistencia de 4 semanas. Se evaluó el Six Minute Walking test (6MWT), el Incremental Shuttle Walk test (ISWT), el Modified Sit and Reach test (MSRT) y la espirometría. Resultados: Se reclutaron 20 niños. No se observaron diferencias significativas entre la pre- y la postintervención en el GC (n = 10). En el 6MWT se observó una mejoría significativa y clínica (316,3 ± 31,4 m vs. 376,2 ± 39,5 m; p=0,002) al final de la intervención en el GI (n = 10). El ISWT (248,0 ± 45,2 m vs. 465,3 ± 58,2 m; p = 0,013), el MSRT (14,5 ± 7,7 cm vs. 22,8 ± 6,9 cm; p=0,003) y la FEV1 (102 ± 16% pred vs. 104 ± 17% pred; p = 0,004) también mejoraron significativamente en el GI. Conclusiones: Este programa de 4 semanas, mejora estadísticamente y clínicamente la tolerancia y la capacidad al ejercicio, y la flexibilidad en niños prematuros con DBP

Bronchopulmonary dysplasia as a risk factor for asthma in school children and adolescents: A systematic review

Background: Bronchopulmonary dysplasia (BPD) is a chronic lung disease that mainly affects extremely pre-term infants, and remains the most common complication of prematurity. Several studies have shown that prematurity predisposes to the development of asthma in school children and adolescents. Nevertheless, it is not clear to what extent a history of BPD involves an additional risk. Methods: A systematic review of studies assessing the association between BPD and asthma in school-children and adolescents was made. A literature search was carried out in the MEDLINE and EMBASE databases to retrieve articles published between 1 January 2000 and 31 August 2016. Results: A total of 17 studies comprising 7433 patients were included in the review. There was considerable heterogeneity in the definitions of BPD and asthma among studies. Overall, the prevalence of asthma was higher in children and adolescents with a history of prematurity and BPD compared with those who did not develop BPD. However, in only one of the studies did this difference reach statistical significance. The main limitation of this review was potential bias due to the lack of adjustment for confounding factors between exposure (BPD) and outcome (asthma) in most of the studies. Conclusion:Based on the studies reviewed, it cannot be argued that BPD, as an independent factor of prematurity, increases the risk of asthma defined by clinical parameters in school-children and adolescents. Further studies of greater methodological quality and homogeneous diagnostic criteria of BPD and asthma are needed for improved assessment of this association (AU)

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Frecuencia de reflujo gastroesofágico ácido en pacientes menores de 2 años con displasia broncopulmonar en el Hospital Infantil de México / Acid gastroesophageal reflux frequency in patients under two years with bronchopulmonary dysplasia at Hospital Infantil de México Federico Gómez

Introducción: La displasia broncopulmonar (DBP) es la enfermedad pulmonar crónica más frecuente que se inicia en la etapa neonatal y afecta a múltiples sistemas. La enfermedad por reflujo gastroesofágico (ERGE) es la patología gastrointestinal más asociada a la DBP. El objetivo del estudio fue establecer la frecuencia de ERGE en lactantes con DBP. Metodología: Estudio observacional, descriptivo y de correlación, con un muestreo no probabilístico. Se incluyeron lactantes con DBP que acudieron a la consulta externa de neumología del Hospital Infantil de México «Federico Gómez». Participaron en el estudio los pacientes que cumplieron con los criterios de selección. Se realizó a los pacientes una pH-metría esofágica, y se registraron los signos y síntomas que presentaron según la hora en que ocurrieron. Resultados: Se incluyeron 20 pacientes, con una mediana de edad de 7,5 meses. El 50% de los pacientes tenía una DBP grave. El síntoma respiratorio sugerente de ERGE más frecuente fue la tos. Se obtuvo una incidencia de ERGE del 40%. Sólo 1 paciente presentó un índice de reflujo patológico, pero el 40% presentó una probabilidad de asociación de síntomas (PAS) para tos mayor del 95%. Todos los pacientes con una puntuación de Euler patológica presentaron una PAS positiva para la tos. No hubo una correlación significativa entre el grado de gravedad de la DBP y el diagnóstico de ERGE (R2= 0,157; p= 0,508). Conclusión: La PAS se debe tener en cuenta como diagnóstico de ERGE en los pacientes con DBP. No hubo correlación entre la gravedad de DBP y ERGE, pero sí una buena correlación entre la positividad de PAS y el índice de Euler en los pacientes con DBP (AU)

Introduction: Bronchopulmonary displasia (BPD) is the most common chronic lung disease that begins in the neonatal period and affects multiple systems. Gastroesophageal reflux disease (GERD) is the gastrointestinal pathology most associated with BPD. The aim of the study was to establish the frequency of GERD in infants with BPD. Material and methods: Observational, descriptive study of correlation, non-probabilistic sampling. Infants with BPD who were attended in the Hospital Infantil de México «Federico Gómez» outpatient pulmonology were included. Those patients who met the selection criteria participated in the study. They underwent to esophageal pH monitoring, registering the signs and symptoms presented by the patient according to the time they occurred. Results: 20 patients were included, with a median age of 7.5 months. 50% of patients had severe BPD. The most common respiratory symptom of GERD suggestive was cough. The incidence of GERD was 40%. Only 1 patient had reflux index (IR) pathological but 40% presented a symptom association probability (SAP) for cough more than 95%. All patients with pathological Euler score showed positive SAP for cough. There was no significant correlation between the severity of DBP and diagnosis of GERD (R2= 0.157; p= 0.508). Conclusion: SAP should be take into account as a diagnosis of GERD in patients with BPD. There was no correlation between the severity of BPD and GERD. There is a good correlation between PAS positivity and Euler index in patients with BPD (AU)

Suplementación de oxígeno en la reanimación neonatal / Oxygen supplementation in neonatal resuscitation

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The fatum of preterm lungs: Every week counts

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Protocolo de seguimiento de los pacientes con displasia broncopulmonar / Guidelines for the follow up of patients with bronchopulmonary dysplasia

La displasia broncopulmonar (DBP) es la secuela más prevalente del recién nacido pretérmino, y sigue suponiendo un motivo frecuente de consulta en las unidades de Neumología Pediátrica. La decisión del alta de la unidad neonatal debe apoyarse en una valoración exhaustiva de la situación clínica del paciente y en el cumplimiento de unos requisitos, que incluyen la estabilidad respiratoria y nutricional, y la instrucción a los cuidadores en el manejo domiciliario. Para un control adecuado de la enfermedad, es necesario que quede establecido, previamente al alta, un calendario de visitas y de exploraciones complementarias, y deben aplicarse las pautas de prevención de exacerbaciones y el tratamiento apropiados. El concepto de DBP como enfermedad multisistémica es fundamental en el seguimiento de los pacientes y debe ser tenido en cuenta para un buen control de la enfermedad. En este documento, el Grupo de Trabajo de Patología Respiratoria Perinatal de la Sociedad Española de Neumología Pediátrica propone un protocolo que sirva como referencia para unificar el seguimiento de los pacientes con DBP entre los diferentes centros y ámbitos asistenciales. Se revisan los aspectos a tener en cuenta en la evaluación previa al alta de la Unidad Neonatal y las principales complicaciones durante el seguimiento. Seguidamente, se detallan las recomendaciones en materia de tratamiento de la enfermedad y prevención de complicaciones, los controles tras el alta y su cronología

Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth, and remains a major problem in pediatric pulmonology units. The decision of discharging from the Neonatal Unit should be based on a thorough assessment of the condition of the patient and compliance with certain requirements, including respiratory and nutritional stability, and caregiver education on disease management. For proper control of the disease, a schedule of visits and complementary tests should be established prior to discharge, and guidelines for prevention of exacerbations and appropriate treatment should be applied. In this paper, the Working Group in Perinatal Respiratory Diseases of the Spanish Society of Pediatric Pulmonology proposes a protocol to serve as a reference for the follow up of patients with BPD among different centers and health care settings. Key factors to consider when planning discharge from the Neonatal Unit and during follow up are reviewed. Recommendations on treatment and prevention of complications are then discussed. The final section of this guide aims to provide a specific schedule for follow-up and diagnostic interventions to be performed in patients with BPD

Importancia del tratamiento de Fisioterapia en el síndrome de dificultad respiratoria y en la displasia broncopulmonar / Importance of Physiotherapy in respiratory distress syndrome and bronchopulmonary dysplasia

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Displasia bronquial moderada: ¿cómo actuar? / No disponible

Las lesiones bronquiales preinvasivas se detectan con escasa frecuencia mediante broncofibroscopia convencional y su manejo posterior sigue planteando numerosas cuestiones en cuanto a la periodicidad y tiempo de seguimiento, así como la necesidad de empleo de broncofibroscopia con fluorescencia y realización de terapia endobronquial. Se presenta el caso de un varón diagnosticado de displasia bronquial moderada mediante broncofibroscopia convencional de luz blanca

reinvasive bronchial lesions are detected infrequently by conventional bronchoscopy. Further management still poses many questions about the frequency, time tracking, and the need for use of fluorescence bronchoscopy and endobronchial therapy. We report the case of a man diagnosed with moderate bronchial dysplasia by conventional bronchoscop

Displasia broncopulmonar: definiciones y clasificación / Bronchopulmonary dysplasia: definitions and classifications

La displasia broncopulmonar sigue siendo la secuela más frecuente relacionada con los recién nacidos de muy bajo peso al nacer y especialmente con aquellos con pesos extremadamente bajos. Pese a los avances en la prevención y los cuidados de la insuficiencia respiratoria asociada a la prematuridad, no ha ocurrido un descenso en su incidencia en esta población, aunque sí hemos asistido en los últimos años a un cambio en su expresión clínica y en su gravedad. Existen, sin embargo, diferencias aún importantes entre los distintos centros en cuanto a la frecuencia de su presentación, probablemente debido a la aplicación de un diagnóstico clínico no homogéneo. En este artículo, la Comisión de Estándares de la Sociedad Española de Neonatología quiere revisar los criterios diagnósticos de la displasia broncopulmonar para reducir, en la medida de lo posible, la variabilidad intercentro de la misma (AU)

Bronchopulmonary dysplasia is the most common sequelae related to very low birth weight infants, mostly with those of extremely low birth weight. Even with advances in prevention and treatment of respiratory distress syndrome associated with prematurity, there is still no decrease in the incidence in this population, although a change in its clinical expression and severity has been observed. There are, however, differences in its frequency between health centres, probably due to a non-homogeneously used clinical definition. In this article, the Committee of Standards of the Spanish Society of Neonatology wishes to review the current diagnosis criteria of bronchopulmonary dysplasia to reduce, as much as possible, these intercentre differences (AU)

Disfunción hepática grave por endotoxemia secundaria a colonización de catéter venoso central / Severe hepatic dysfunction due to endotoxemia secondary to central venous catheter bacterial colonisation

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