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Fetal intervention in congenital malformations of the respiratory system
Key points Congenital malformations of the respiratory system consist of a wide range of fetal anomalies that can affect the developing of the fetal lungs. Most congenital malformations of the respiratory system can be diagnosed prenatally by identifying hyperechoic lung…
Genetic disorders of alveolar formation and homeostasis
Key points Lung morphogenesis begins with the formation of the tracheal and bronchial buds. Subsequent branching morphogenesis forms the respiratory tubules, the acini, and the alveolar regions of the lung required for gas exchange after birth. Lung morphogenesis is dependent…
The neonatal lung: Lung imaging using ultrasound and electric impedance tomography
Key points Lung ultrasound and electrical impedance tomography are point-of-care imaging modalities that provide continuous, radiation-free bedside lung imaging. Lung ultrasound relies on the interpretation of reproducible ultrasound artifact patterns that correspond to the degree of lung aeration. It has…
Caffeine—respiratory stimulant or magic bullet?
Key points Caffeine is the respiratory stimulant of choice to prevent or treat apnea of prematurity. The standard loading is 20 mg/kg of caffeine citrate, and the daily maintenance dose is 5 to 10 mg Beneficial effects of this caffeine…
Perinatal nutrition and the lung
Key points Lung development is influenced by both prenatal and postnatal nutrient quality and quantity. The wide spectrum of maternal and preterm infant nutritional states has differing impacts on the trajectory of fetal-infant lung development. Specific nutrient supplements given during…
Long-term pulmonary outcome of preterm infants
Key points Preterm infants are vulnerable to adverse long-term sequelae including pulmonary outcomes. Respiratory morbidities, including hospitalizations for respiratory infections, asthma, and wheezing illnesses, are higher in those born preterm compared with term. These risks decrease as the children get…
A physiology-based approach to the respiratory care of children with severe bronchopulmonary dysplasia
Key points Despite advances in perinatal care, including many innovations in cardiorespiratory management of extremely preterm infants, the incidence of bronchopulmonary dysplasia (BPD) and its severity has not decreased over time and remains a major public health problem. Severe BPD…
Definitions and diagnostic criteria of bronchopulmonary dysplasia: Clinical and research implications
Key points Bronchopulmonary dysplasia (BPD) is a common complication of prematurity that results from abnormal lung development and injury that leads to chronic impairment of lung function. Use of standardized diagnostic classifications of BPD and its severity is important in…
Cell-based therapy for neonatal lung diseases
Key points The postnatal lung contains populations of stem cells that reconstitute the lung following injury. Prematurity and its antecedent factors alter endogenous stem cells leading to dysfunctional lung repair. Preterm infants who develop bronchopulmonary dysplasia (BPD) exhibit decreased and/or…