Bronchopulmonary dysplasia - a chronic lung disease that affects infants, who needed mechanical ventilation. This disorder occurs in infants who received prolonged periods of oxygen in large volumes.

Causes and risk factors

In most cases, these are children who were born at 34 weeks gestation and weighed before and at birth of less than 2000 grams. They are the most vulnerable to such violation as infant respiratory distress syndrome, which is caused by damage to the lung tissue due to prolonged mechanical ventilation.

Air is introduced through a tube inserted into the trachea. Sometimes, the child survived, the concentration of oxygen in the air should be higher than the air we normally breathe. Although mechanical ventilation is crucial for survival, eventually the pressure that it causes, and an excess of oxygen can damage the delicate baby's lungs.

Bronchopulmonary dysplasia can occur as a result of other factors, such as trauma, pneumonia, and other infections. All of this can cause typical of bronchopulmonary dysplasia inflammation and scarring, even in babies born at term, and very rare in infants and older children.

For unknown reasons, ceteris paribus have preterm boys bronchopulmonary dysplasia is more common than in girls.

Diagnostics

As a rule, bronchopulmonary dysplasia is diagnosed if the child is still required mechanical ventilation and / or he has symptoms of respiratory problems at the age of 28 days. Sometimes the diagnosis is chest X-ray.

Treatment

Children diagnosed with bronchopulmonary dysplasia undergo intensive therapy, as long as they are able to breathe on their own. In the most well-equipped hospitals and used equipment, which reduces the damage that involve mechanical ventilation. Children are also given various drugs that support the lungs. Among them - bronchodilators, allowing the airways to remain open, and diuretics, which prevent the fluid accumulation in the lungs.

In severe cases, patients with bronchopulmonary dysplasia is assigned a short-term course of a steroid drug. These powerful anti-inflammatory drugs have serious side effects; doctors give their children only after their parents to discuss the risks and benefits associated with taking steroids.

Because of the high likelihood of developing pneumonia sick children can also give antibiotics Antibiotics - whether they will help you in the foreseeable future? .

Furthermore, mixtures of high-calorie feed children, to provide them with the necessary nutrients for growth and energy.

In severe cases, patients with bronchopulmonary dysplasia Dysplasia - what is it?   children can not digest food. They make special intravenous nutrient mixtures, which include fat, protein, sugar and various nutrients.

Children with bronchopulmonary dysplasia is carried out in the hospital a few weeks to several months. The average duration of therapy for these children is 120 days. After graduating children often require treatment at home.

Most children need for supplemental oxygen disappears by the end of the first year of life, but some of it must be within a few years or even a lifetime (although this is rare).

The condition of patients is improving gradually. Lungs continue to grow for five to seven years, and some children even at school age minor anomalies observed in lung function.

Complications

Children who have been diagnosed with bronchopulmonary pneumonia, as a rule, are more susceptible to infections than other children. Furthermore, they are heavier than the transmission of infectious diseases. Other complications of bronchopulmonary dysplasia can be accumulation of fluid in the body, making it difficult for air movement airway.

Sometimes I have had bronchopulmonary dysplasia children develop various complications related to the cardiovascular system, such as pulmonary hypertension Hypertension - Control your blood pressure .

Complications associated with drug treatment, can be:

• Dehydration and reduction of sodium levels in the body by the action of diuretics;
• Kidney stones, hearing problems, and low levels of potassium and calcium in the blood.

Many children who have had bronchopulmonary dysplasia, grow more slowly and with difficulty peers gaining weight. Children born prematurely and have undergone bronchopulmonary dysplasia, often ill cerebral palsy. In general, however, the risk of permanent serious complications bolevshih bronchopulmonary dysplasia, is relatively low.

Pneumoconiosis - a group of chronic diseases that develop due to prolonged inhalation of dust and are accompanied by the growth of connective tissue in the lungs. Pneumoconiosis belong to the group of occupational diseases, as are commonly found in workers of engineering, coal, mining and other industries.

Types of pneumoconiosis

Depending on the type of respirable dust are the following types of the disease:

• Silicosis - pneumoconiosis that develops from inhaling silica dust;
• Asbestosis - a disease that occurs when the light enters the dust containing silicon dioxide particles and talc, asbestos, cement, mica, or certain other substances;
• Karbokonioz developed by inhalation of coal dust;
• Metallokonioz - pneumoconiosis caused by dust of various metals (aluminum, iron, barium, tin);
• "Pneumoconiosis welders 'and' pneumoconiosis polishers" developed by inhalation of dust mixed;
• Pneumoconiosis that is associated with the inhalation of organic dust particles of animal or vegetable origin.

By the nature of the disease is also divided into several groups:

• Rapidly progressive pneumoconiosis in which the initial symptoms of the disease are detected within three years after the beginning of exposure to dust;
• Slowly progressive form. The first signs of proliferation of connective tissue (fibrosis) in the lungs appear only ten years after the start of operation in dusty conditions;
• Late pneumoconiosis developed a few years after a person stops in contact with dust;
• Regress forms which are found only in the accumulation of particles in the lungs radiopaque dust. Because of this, when viewing the X-ray gives the impression that fibrosis in the lungs is more pronounced than in reality. Once the patient stops the contact with the dust, dust particles are gradually eliminated from the lungs, to radiograph and reduced the severity of the pathological process.

Symptoms

In the initial stages of the disease symptoms are mild pneumoconiosis. Is worried a little dry cough, chest pain and shortness of breath during exercise. Later joined by chronic bronchitis and emphysema (increased airiness of lung tissue).

Later signs of respiratory failure are enhanced, and in the later stages of developing pulmonary heart - circulatory insufficiency due to the disruption of the right ventricle. This state - the cause of death of most patients with pneumoconiosis.

Silicosis - the most common form of pneumoconiosis, which often takes very seriously. The more of respirable dust contains no free silica, the faster the disease progresses. Due to the proliferation of connective tissue in lung, bronchitis and emphysema is shortness of breath. Dust irritates the mucous membranes of the upper respiratory tract, which is why there is a dry cough Dry cough - whether to worry about it? . If dust particles fall through the lymphatic system in the pleural cavity, there are formed adhesions Adhesions - how to get rid of them?   - Seam pleural sheets. In patients with a feeling of stiffness, pain and tingling in the shoulder blades and under them.

A benign asbestosis, silicosis than Silicosis - a serious occupational disease . The exception to this group of pneumoconiosis is asbestosis (developed by inhalation of dust which contains asbestos). Mineral has a fibrous structure, because of this dust it causes not only the proliferation of connective tissue, but also damage the mucous membrane of the respiratory tract and lung tissue stronger than other types of industrial dust. Therefore, asbestosis symptoms are more severe and progress more quickly than the rest of asbestosis.

When karbokoniozah metallokoniozah and symptoms of the disease is usually expressed moderately. Upon contact with the dust, which is of organic origin (cotton, flax, wool), develop disease resembling asthma and alveolitis Alveolitis - possible irreversible changes in the lungs   (inflammation of pulmonary alveoli). But fibrosis does not develop in all cases. Because of this disease, which occur by inhalation of organic dust pneumoconiosis are conditional.

Diagnostics

X-rays - the most important method for the diagnosis of pneumoconiosis. Be sure to carry out a survey radiography, and if necessary, make a side and enlarged images. Evaluation of respiratory function as part of a complex examination of patients.

In severe cases, computed tomography helps to distinguish from other diseases pneumoconiosis. Sometimes, to clarify the diagnosis is carried out bronchoscopy with biopsy (examination of the bronchial mucosa using a special tool and a fence of cells and tissues), and then examine the resulting material.

We should also be taken into account especially the profession of the patient. Exploring the possibility of human contact with dust, the duration of such adverse conditions, the concentration and composition of dust.

Treatment and prevention

Treatment and prevention efforts should include proper organization of work and rest, a diet rich in vitamins and proteins, breathing exercises and smoking cessation. Patients received vitamins B1, B5, C and adaptogens - drugs that have obschestimuliruyuschim effect on the body. These include tincture Chinese magnolia vine and Eleutherococcus.

If the patient has no respiratory failure or she expressed slightly, it is recommended iontophoresis with calcium chloride, procaine, ultrasound or diadynamic currents on the chest. These procedures improve blood circulation in the lung and their reduced respiratory function. If there are signs of bronchitis are used expectorants and mucus-thinning drugs (eg, thermopsis, drugs alteynogo root). With increased viscosity of sputum appointed by the inhalation of enzyme preparations (trypsin or lidazy).

In cases where the patient's worries expressed respiratory insufficiency, treatment is carried out in a hospital or a specialized nursing home. Assign inhaled oxygen or hyperbaric oxygenation (use of oxygen above atmospheric pressure). Recommended drugs that enhance the bronchi, and means for reducing the pressure in the pulmonary vessels. If developing pulmonary heart, the use of cardiac glycosides (digoxin, strophanthin), potassium supplements and diuretics (furosemide).

People who work in dusty conditions, must undergo periodic medical examinations. This will allow early detection of early signs of pneumoconiosis and start treatment.

Alexander Chernov