Monatsschrift Kinderheilkunde

, Volume 153, Issue 3, pp 211–219 | Cite as

Bronchopulmonale Dysplasie Frühgeborener

Epidemiologie, Pathogenese und Therapie
Leitthema: Chronische Bronchitis

Zusammenfassung

Seit der Erstbeschreibung durch Northway et al. hat sich das klinische Bild der bronchopulmonalen Dysplasie (BPD) deutlich gewandelt. Hochrisikogruppe für die „neue“ BPD sind beatmete Frühgeborene mit einem Geburtsgewicht <1000 g. Prä- und postnatale Infektionen, Volutrauma durch Beatmung sowie toxische Sauerstoffmetaboliten sind bei ihnen in der Lage, eine pulmonale Entzündung zu initiieren und zu unterhalten, die in einer gestörten Lungenentwicklung münden kann. Die Praxis, diese Kinder in niedrigeren Sauerstoffsättigungsbereichen zu halten, reduziert die pulmonale Morbidität, ohne die langfristige neurologische und somatische Entwicklung negativ zu beeinflussen. Die Indikation für systemische Glukokortikoide ist wegen erheblicher kurz- und langfristiger Risiken extrem restriktiv zu sehen. Diuretika und Bronchodilatoren können die Lungenfunktion von Kindern mit BPD kurzfristig verbessern. Der Nutzen einer Therapie mit diesen Medikamenten ist jedoch nicht durch prospektiv-randomisierte Studien gesichert.

Schlüsselwörter

Bronchopulmonale Dysplasie Chronische Lungenerkrankung Pathogenese Sauerstofftherapie Glukokortikoide 

Bronchopulmonary dysplasia

Epidemiology, pathogenesis and treatment

Abstract

Since it was first described by Northway the clinical pattern of bronchopulmonary dysplasia (BPD) has changed substantially. Ventilated preterm infants with a birth weight <1000 g are the high-risk group for the “new” of BPD. In these infants pre- and postnatal infections, ventilation-induced volutrauma and oxygen toxicity can initiate and sustain a pulmonary inflammatory response with the possible consequence of impaired development of the lung. The practice of targeting these infants at lower oxygen levels reduces pulmonary morbidity without affecting the long-term neurological or somatic outcome. Systemic glucocorticoids must be used very restrictively because of severe short- and long-term hazards. Diuretics and bronchodilators can improve the lung function of infants with BPD in the short term, but the benefit of a therapy with these medications has not yet been confirmed in randomized, prospective studies.

Keywords

Bronchopulmonary dysplasia Chronic lung disease Pathogenesis Oxygen inhalation therapy Glucocorticoids 

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Copyright information

© Springer Medizin Verlag 2005

Authors and Affiliations

  1. 1.Universitäts-KinderklinikWürzburg
  2. 2.Universitäts-KinderklinikkWürzburg

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