Chronic lung disease (CLD) is a general term used to describe long-term respiratory problems in premature babies. It is also known as bronchopulmonary dysplasia (BPD). It results from progressive lung injury in newborns who require chronic respiratory support with breathing (mechanical ventilation, oxygen therapy etc.).
CLD causes respiratory distress (fast breathing, laboured breathing) in the baby. There is a continued need for mechanical ventilation or extra oxygen support after the premature baby reaches 36 weeks gestational age.
The risk of developing CLD can be reduced by medical treatment of early newborn disease such as surfactant therapy and PDA closure. A shorter duration of mechanical ventilation can also help reduce the risk of CLD, but this has to be balanced with the necessity of ventilation support in premature infants. Ensuring optimal nutrition will help baby’s lungs to develop and grow. Prevention and timely treatment of infection can minimise further injury to already vulnerable lungs.
Prematurity, low birthweight, maternal infection, and other conditions like patent ductus arteriosus (PDA) and infections, are all factors that put the newborn at risk of developing CLD.
CLD is diagnosed by the baby’s need for oxygen support beyond 28 days, and is classified as mild, moderate or severe depending on the baby’s requirement for supplemental oxygen at 36 weeks of gestational age.
Treatment options include steroids to reduce inflammation or get the baby off the ventilator, diuretics to reduce excess fluid in the lungs, antibiotics to fight infection and bronchodilators to help open up airways. Good nutrition is also important in helping the lungs develop optimally. Babies with CLD are also offered specially immunization against lung infection by respiratory syncytial virus and flu. Babies will need ongoing follow up as they run the risk of developing sensitive airways in future and hospitalisation triggered by infection.
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