超声监测下管理肺疾病:或使早产儿支气管肺发育不良成为可避免的疾病

刘敬

中国当代儿科杂志 ›› 2024, Vol. 26 ›› Issue (1) : 14-18.

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中国当代儿科杂志 ›› 2024, Vol. 26 ›› Issue (1) : 14-18. DOI: 10.7499/j.issn.1008-8830.2309120
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超声监测下管理肺疾病:或使早产儿支气管肺发育不良成为可避免的疾病

  • 刘敬
作者信息 +

Management of lung diseases under ultrasound monitoring: potential to make bronchopulmonary dysplasia in preterm infants as an avoidable disease

  • LIU Jing
Author information +
文章历史 +

摘要

支气管肺发育不良(bronchopulmonary dysplasia, BPD)是早产儿最常见的慢性肺部疾病,虽然对其病因、机制、预防和治疗的研究取得了重要进展,但预后并没有明显改善。BPD患儿不仅病死率高,对存活者也造成呼吸、神经、心脏等多方面的持久性损害。作者团队在肺脏超声监测下管理新生儿肺疾病,在过去近7年的时间里避免了BPD的发生,为BPD的预防开辟了新途径。该文对此予以简介,以期加强相关研究,为预防或最大程度减少BPD的发生提供更加科学的管理方案。

Abstract

Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease in preterm infants. Despite significant progress in the understanding of its etiology, mechanisms, prevention, and treatment, the prognosis remains poor. BPD not only has a high mortality rate but also causes persistent respiratory, neurological, and cardiovascular impairments in survivors. The author's team has successfully prevented the occurrence of BPD by managing neonatal lung diseases under lung ultrasound monitoring for nearly 7 years, opening up a new approach in BPD prevention. This article provides a brief overview of the approach, aiming to facilitate further research and provide more scientifically sound management strategies to prevent or minimize the occurrence of BPD.

关键词

支气管肺发育不良 / 慢性肺疾病 / 肺脏超声 / 诊断标准 / 早产儿

Key words

Bronchopulmonary dysplasia / Chronic lung disease / Lung ultrasound / Diagnostic criteria / Preterm infant

引用本文

导出引用
刘敬. 超声监测下管理肺疾病:或使早产儿支气管肺发育不良成为可避免的疾病[J]. 中国当代儿科杂志. 2024, 26(1): 14-18 https://doi.org/10.7499/j.issn.1008-8830.2309120
LIU Jing. Management of lung diseases under ultrasound monitoring: potential to make bronchopulmonary dysplasia in preterm infants as an avoidable disease[J]. Chinese Journal of Contemporary Pediatrics. 2024, 26(1): 14-18 https://doi.org/10.7499/j.issn.1008-8830.2309120

参考文献

1 Bancalari E, Jain D. Bronchopulmonary dysplasia: 50 years after the original description[J]. Neonatology, 2019, 115(4): 384-391. PMID: 30974430. DOI: 10.1159/000497422.
2 Gilfillan M, Bhandari A, Bhandari V. Diagnosis and management of bronchopulmonary dysplasia[J]. BMJ, 2021, 375: n1974. PMID: 34670756. DOI: 10.1136/bmj.n1974.
3 Schmidt AR, Ramamoorthy C. Bronchopulmonary dysplasia[J]. Paediatr Anaesth, 2022, 32(2): 174-180. PMID: 34877749. DOI: 10.1111/pan.14365.
4 Abiramalatha T, Ramaswamy VV, Bandyopadhyay T, et al. Interventions to prevent bronchopulmonary dysplasia in preterm neonates: an umbrella review of systematic reviews and meta-analyses[J]. JAMA Pediatr, 2022, 176(5): 502-516. PMID: 35226067. DOI: 10.1001/jamapediatrics.2021.6619.
5 Jobe AH, Abman SH. Bronchopulmonary dysplasia: a continuum of lung disease from the fetus to the adult[J]. Am J Respir Crit Care Med, 2019, 200(6): 659-660. PMID: 31091958. PMCID: PMC6775887. DOI: 10.1164/rccm.201904-0875ED.
6 Lal CV, Kandasamy J, Dolma K, et al. Early airway microbial metagenomic and metabolomic signatures are associated with development of severe bronchopulmonary dysplasia[J]. Am J Physiol Lung Cell Mol Physiol, 2018, 315(5): L810-L815. PMID: 30113227. PMCID: PMC6295508. DOI: 10.1152/ajplung.00085.2018.
7 Pammi M, Lal CV, Wagner BD, et al. Airway microbiome and development of bronchopulmonary dysplasia in preterm infants: a systematic review[J]. J Pediatr, 2019, 204: 126-133.e2. PMID: 30297287. DOI: 10.1016/j.jpeds.2018.08.042.
8 Deng X, Bao Z, Yang X, et al. Molecular mechanisms of cell death in bronchopulmonary dysplasia[J]. Apoptosis, 2023, 28(1-2): 39-54. PMID: 36369365. DOI: 10.1007/s10495-022-01791-4.
9 Leong M. Genetic approaches to bronchopulmonary dysplasia[J]. Neoreviews, 2019, 20(5): e272-e279. PMID: 31261079. DOI: 10.1542/neo.20-5-e272.
10 Luo X, Zhao M, Chen C, et al. Identification of genetic susceptibility in preterm newborns with bronchopulmonary dysplasia by whole-exome sequencing: BIVM gene may play a role[J]. Eur J Pediatr, 2023, 182(4): 1707-1718. PMID: 36757497. PMCID: PMC10167099. DOI: 10.1007/s00431-022-04779-z.
11 Parad RB, Winston AB, Kalish LA, et al. Role of genetic susceptibility in the development of bronchopulmonary dysplasia[J]. J Pediatr, 2018, 203: 234-241.e2. PMID: 30287068. PMCID: PMC8516345. DOI: 10.1016/j.jpeds.2018.07.099.
12 Abdellatif MAK, Eyada E, Rabie W, et al. Genetic and biochemical predictors of neonatal bronchopulmonary dysplasia[J]. J Pediatr Genet, 2022, 11(3): 173-178. PMID: 35990034. PMCID: PMC9385253. DOI: 10.1055/s-0040-1721740.
13 Tian C, Li D, Fu J. Molecular mechanism of caffeine in preventing bronchopulmonary dysplasia in premature infants[J]. Front Pediatr, 2022, 10: 902437. PMID: 35795332. PMCID: PMC9251307. DOI: 10.3389/fped.2022.902437.
14 Doyle LW. Postnatal corticosteroids to prevent or treat bronchopulmonary dysplasia[J]. Neonatology, 2021, 118(2): 244-251. PMID: 33975319. DOI: 10.1159/000515950.
15 Ferrante G, Montante C, Notarbartolo V, et al. Antioxidants: role the in prevention and treatment of bronchopulmonary dysplasia[J]. Paediatr Respir Rev, 2022, 42: 53-58. PMID: 35177319. DOI: 10.1016/j.prrv.2022.01.003.
16 Gentle SJ, Rysavy MA, Li L, et al. Heterogeneity of treatment effects of hydrocortisone by risk of bronchopulmonary dysplasia or death among extremely preterm infants in the National Institute of Child Health and Human Development Neonatal Research Network Trial: a secondary analysis of a randomized clinical trial[J]. JAMA Netw Open, 2023, 6(5): e2315315. PMID: 37256621. PMCID: PMC10233424. DOI: 10.1001/jamanetworkopen.2023.15315.
17 Siffel C, Kistler KD, Lewis JFM, et al. Global incidence of bronchopulmonary dysplasia among extremely preterm infants: a systematic literature review[J]. J Matern Fetal Neonatal Med, 2021, 34(11): 1721-1731. PMID: 31397199. DOI: 10.1080/14767058.2019.1646240.
18 Liu J, Zhang X, Wang Y, et al. The outcome- or cost-effectiveness analysis of LUS-based care or CXR-based care of neonatal lung diseases: the clinical practice evidence from a level Ⅲ NICU in China[J]. Diagnostics (Basel), 2022, 12(11): 2790. PMID: 36428848. PMCID: PMC9689125. DOI: 10.3390/diagnostics12112790.
19 Homan TD, Nayak RP. Short- and long-term complications of bronchopulmonary dysplasia[J]. Respir Care, 2021, 66(10): 1618-1629. PMID: 34552015. DOI: 10.4187/respcare.08401.
20 刘选成, 谷名晓, 孙萌, 等. 支气管肺发育不良患儿婴儿期下呼吸道感染的临床特征及病原学分析[J]. 中国当代儿科杂志, 2023, 25(9): 953-958. PMID: 37718402. PMCID: PMC10511232. DOI: 10.7499/j.issn.1008-8830.2304076.
21 Katz TA, Vliegenthart RJS, Aarnoudse-Moens CSH, et al. Severity of bronchopulmonary dysplasia and neurodevelopmental outcome at 2 and 5 years corrected age[J]. J Pediatr, 2022, 243: 40-46.e2. PMID: 34929243. DOI: 10.1016/j.jpeds.2021.12.018.
22 中华医学会儿科学分会新生儿学组, 中华儿科杂志编辑委员会. 早产儿支气管肺发育不良临床管理专家共识[J]. 中华儿科杂志, 2020, 58(5): 358-365. PMID: 32392950. DOI: 10.3760/cma.j.cn112140-20200317-00254.
23 Jobe AH, Bancalari E. Bronchopulmonary dysplasia[J]. Am J Respir Crit Care Med, 2001, 163(7): 1723-1729. PMID: 11401896. DOI: 10.1164/ajrccm.163.7.2011060.
24 Liu J, Chen SW, Liu F, et al. BPD, not BPD, or iatrogenic BPD: findings of lung ultrasound examinations[J]. Medicine (Baltimore), 2014, 93(23): e133. PMID: 25415666. PMCID: PMC4616337. DOI: 10.1097/MD.0000000000000133.
25 Gao YQ, Qiu RX, Liu J, et al. Lung ultrasound completely replaced chest X-ray for diagnosing neonatal lung diseases: a 3-year clinical practice report from a neonatal intensive care unit in China[J]. J Matern Fetal Neonatal Med, 2022, 35(18): 3565-3572. PMID: 33032479. DOI: 10.1080/14767058.2020.1830369.
26 Liu J, Xia RM, Ren XL, et al. The new application of point-of-care lung ultrasound in guiding or assisting neonatal severe lung disease treatment based on a case series[J]. J Matern Fetal Neonatal Med, 2020, 33(23): 3907-3915. PMID: 30835592. DOI: 10.1080/14767058.2019.1590332.
27 Liu J, Lovrenski J, Ye Hlaing A, et al. Neonatal lung diseases: lung ultrasound or chest X-ray[J]. J Matern Fetal Neonatal Med, 2021, 34(7): 1177-1182. PMID: 31220971. DOI: 10.1080/14767058.2019.1623198.
28 Qiu RX, Ren XL, Liu J, et al. Bronchoalveolar lavage to treat neonatal meconium aspiration syndrome under monitoring of lung ultrasound based on a prospective case series study[J]. Iran J Pediatr, 2019, 29(4): e90012. DOI: 10.5812/ijp.90012.
29 Liu J, Zhao HR, Wei HL, et al. Efficacy of bronchoalveolar lavage as adjunct therapy in the treatment of neonatal severe pneumonia: a prospective case-control study[J]. J Trop Pediatr, 2020, 66(5): 528-533. PMID: 32065644. DOI: 10.1093/tropej/fmaa010.
30 Ren XL, Wang M, Liu J, et al. The application of point-of-care lung ultrasound in the precise nursing of neonatal severe pneumonia[J]. Chest, 2019, 155(4): 87A. DOI: 10.1016/j.chest.2019.02.086.
31 Liu J, Fu W, Qin SJ. Lung ultrasound to guide the administration of exogenous pulmonary surfactant in respiratory distress syndrome of newborn infants: a retrospective investigation study[J]. Front Pediatr, 2022, 10: 952315. PMID: 36340730. PMCID: PMC9635001. DOI: 10.3389/fped.2022.952315.
32 刘敬. 肺脏超声对早产儿支气管肺发育不良的预测及诊断价值[J]. 江苏大学学报(医学版), 2022, 32(2): 104-107. DOI: 10.13312/j.issn.1671-7783.y210183.

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