Title Kronična plućna bolest nedonoščadi
Title (english) Chronic lung disease in premature infants
Author Iva Topić
Mentor Emilja Juretić (mentor)
Committee member Mirta Starčević (predsjednik povjerenstva)
Committee member Marija Jelušić (član povjerenstva)
Committee member Emilja Juretić (član povjerenstva)
Granter University of Zagreb School of Medicine (Department of Pediatrics) Zagreb
Defense date and country 2018-07-13, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Pediatrics
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Gynecology and Obstetrics
Abstract Kronična plućna bolest je bolest pluća koja nastaje akutnim zbivanjem u novorođenačkom razdoblju. Većina nastaje iz bronhopulmonalne displazije, koja se uobičajeno opisuje kao posljedica liječenja respiratornog distres sindroma u nedonoščadi kisikom i mehaničkom ventilacijom. Definira se kao ovisnost o dodatnom kisku u trajanju duljem od 28 dana. Bronhopulmonalna displazija se prvenstveno objašnjava kao razvojni poremećaj izuzetno nedonošene djece u kojemu prijevremeni porod i preuranjeni početak izmjene plinova interferiraju s normalnim razvojem alveola i plućnih krvnih žila. Tijekom ovog ranog razvojnog stadija, čak i minimalna izloženost štetnim čimbenicima, kao što su mehanička ventilacija, toksično djelovanje kisika ili infekcija, može poremetiti ovaj proces. Prevencija kronične plućne bolesti prvenstveno je usmjerena na prevenciju prijevremenog poroda. Od ostalih strategija koriste se manje invazivni oblici mehaničke ventilacije, primjena surfaktanta, sprječavanje prekomjerne izloženosti kisiku, terapija kofeinom i dr. Glavni cilj liječenja je svođenje daljnje ozljede pluća na što manju razinu, usporedno stvarajući optimalne uvjete za rast i oporavak. U većine pacijenata s cijeljenjem i rastom pluća dolazi do postupnog poboljšanja. Cilj ovog rada bio je prikazati obilježja djece rođene u Klinici za ženske bolesti i porode KBC-a Zagreb tijekom 2017. koja su zahtijevala nadomjesnu terapiju kisikom najmanje 28 dana nakon poroda. U navedenom periodu rođeno je ukupno 41 takvo dijete, što odgovara incidenciji od 1%. Većina novorođenčadi rođena je prije navršenog 28. tjedna gestacije i rodne mase manje od 1000 g. Incidencija i težina kliničke slike bronhopulmonalne displazije bile su obrnuto proporcionalne gestacijskoj dobi i rodnoj masi. Ostali promatrani rizični čimbenici uključivali su intrauterini zastoj u rastu, Apgar ocjenu, izloženost kisiku i vrste respiratorne potpore. Ovo istraživanje deskriptivne je naravi, a provedeno je na relativno malom uzorku, te zbog toga nije pouzdano u donošenju općenitih zaključaka.
Abstract (english) Chronic lung disease is a respiratory disease that usually evolves from an acute respiratory disorder experienced by a newborn infant. The majority of cases arise from bronchopulmonary dysplasia, which is usually described as a disease subsequent to oxygen and/or ventilator therapy for respiratory distress syndrome in preterm newborns. It is defined by oxygen requirement for at least 28 days. Bronchopulmonary dysplasia is primarily interpreted as a developmental disorder in extremely premature infants in which premature birth and the initiation of pulmonary gas exchange at this early stage appear to interrupt the normal alveolar and vascular growth. At this early developmental stage, even minimal exposure to injurious factors, such as mechanical ventilation, oxygen toxicity, or infection, may interrupt this process. Prevention of chronic lung disease is primarily focused on preventing preterm birth. Other strategies include the use of less invasive mechanical ventilation strategies, surfactant administration, prevention of excess oxygen exposure, caffeine therapy, etc. Management is directed at minimizing further injury and providing an optimal environment to support growth and recovery. Most patients gradually improve as healing occurs and lung growth continues. The aim of this thesis was to present the characteristics of infants born at the Department of Gynecology and Obstetrics, University Hospital Center Zagreb, in the year 2017, who required supplemental oxygen for at least 28 postnatal days. During this period, 41 such infants were born, which corresponds to an incidence of 1%. The majority of newborns were born before 28 weeks of gestation and weighing less than 1000 g. The incidence of bronchopulmonary dysplasia, as well as the severity of the disease, increased with decreasing gestational age and birth weight. Additional risk factors that were observed include intrauterine growth restriction, Apgar score, exposure to oxygen and respiratory support modalities. This descriptive research was carried out on a relatively small sample and therefore it is not reliable in making general conclusions.
Keywords
kronična plućna bolest
bronhopulmonalna displazija
nedonošče
mehanička ventilacija
kisik
Keywords (english)
chronic lung disease
bronchopulmonary dysplasia
prematurity
mechanical ventilation
oxygen
Language croatian
URN:NBN urn:nbn:hr:105:375628
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2018-12-20 13:54:57