ʻO ka displasia Bronchopulmonary

ʻO Bronchopulmonary dysplasia (BPD) kahi manawa lōʻihi (mau) i loaʻa i nā pēpē hou i kau ʻia i ka mīkini hanu ma hope o ka hānau ʻana a hānau mua ʻia paha (prematurely).

Hana ʻia ʻo BPD i nā pēpē maʻi loa i loaʻa nā kiʻekiʻe o ka oxygen no nā wā lōʻihi. Hiki pū kekahi ʻo BPD i nā pēpē i noho ma ka mīkini hanu (ventilator).

ʻOi aku ka maʻamau o ka BPD i nā pēpē i hānau mua ʻia (prematurely), nona nā māmā i hoʻomohala ʻole ʻia i ka wā hānau.

ʻO nā kumu pilikia me:

• ʻO ka maʻi puʻuwai Congenital (pilikia me ka hanana o ka puʻuwai a me ka hana e kū nei ma ka hānau ʻana)
• Prematurity, maʻa mau i nā pēpē i hānau ma mua o 32 mau pule hāpai
• ʻO ka maʻi hanu nui a maʻi pūhū paha

Ua emi ka pilikia o ka BPD koʻikoʻi i nā makahiki i hala iho nei.

Pākuʻi ʻia paha nā ʻōuli i kekahi o kēia mau mea:

• ʻO kaʻili o kaʻili Bluish (cyanosis)
• Cough
• Hanu wikiwiki
• Pokole o ka hanu

Nā hoʻokolohua e hana ʻia paha e kōkua ai i ka hōʻoia ʻana i ka BPD:

• Ke kinoea koko arterial
• Scanner CT pahu
• Pākuʻi x-ray
• Pulse oximetry

MA KA HOSPITAL

Hoʻokomo pinepine ʻia nā pēpē i loaʻa i nā pilikia hanu i ka ventilator. ʻO kēia kahi mīkini hanu e hoʻouna i ke kaomi i nā māmā o ka pēpē e hoʻonui iā lākou a e hāʻawi i ka oxygen hou aʻe. Ke ulu nei nā māmā o ka pēpē, hoʻemi haʻahaʻa ʻia ke kaomi a me ka oxygen. Ua ukuhi ʻia ka pēpē mai ka ea. E hoʻomau ka loaʻa ʻana o ka oxygen i ka pēpē e kahi pale a i ʻole nasal Tube no kekahi mau pule a i ʻole mau mahina.

Hānai pinepine ʻia nā pēpē me BPD e nā paipu i hoʻokomo ʻia i loko o ka ʻōpū (NG tube). Pono kēia mau pēpē i nā calorie keu ma muli o ka hoʻāʻo o ka hanu ʻana. No ka mālama ʻana i kā lākou mau māmā mai ka hoʻopiha ʻana me ka wai, pono e kaupalena ʻia kā lākou lawe wai. Hāʻawi ʻia lākou i nā lāʻau (diuretics) e hoʻoneʻe i ka wai mai ke kino. Hiki i nā lāʻau ʻē aʻe ke komo pū me nā corticosteroids, bronchodilators, a me surfactant. ʻO ka Surfactant kahi mea paheʻe, like me ke kopa i loko o nā akemāmā e kōkua ai i nā māmā e hoʻopiha me ka ea a mālama i nā ʻeke lewa mai ka hoʻoliʻiliʻi.

Pono nā mākua o kēia pēpē i ke kākoʻo naʻau. ʻO kēia no ka mea ʻo BPD ka manawa e hoʻomaikaʻi ai a pono paha ka pēpē e noho i ka haukapila no kahi manawa lōʻihi.

I KA HOME

Pono paha nā pēpē me ka BPD i ka hoʻokele oxygen no mau pule i mau mahina ma hope o ka haʻalele ʻana i ka haukapila. E hāhai i nā ʻōlelo aʻoaʻo a kāu kahu mālama ola e hōʻoia i ka lawa pono o kāu pēpē i ka wā o ke ola. Pono paha i kāu pēpē i ka hānai ʻana i ka paipu a i ʻole nā ​​haʻina kūikawā.

He mea nui e pale aku i kāu pēpē mai ke anu a me nā maʻi ʻino ʻē aʻe, e like me ka maʻi hanu syncytial respiratory (RSV). Hiki i ka RSV ke hana i kahi maʻi maʻi māmā, keu hoʻi i kahi pēpē me BPD.

ʻO kahi ala maʻalahi e pale aku ai i ka maʻi ʻo RSV ka holoi pinepine ʻana i kou mau lima. E hāhai i kēia mau ana:

• E holoi i kou mau lima me ka wai mehana a me ke kopa ma mua o ka pā ʻana i kāu pēpē. E haʻi i nā poʻe ʻē aʻe e holoi i ko lākou mau lima, ma mua o ka pā ʻana i kāu pēpē.
• E noi i nā poʻe ʻē aʻe e hōʻalo i ka launa ʻana me kāu pēpē inā loaʻa iā lākou ke anu a fiva paha, a i ʻole e noi iā lākou e komo i kahi pale maka
• E makaʻala i ka honi ʻana i kāu pēpē hiki ke hoʻolaha iā RSV.
• E hoʻāʻo e pale aku i nā keiki ʻōpio mai kāu pēpē. ʻO ka maʻamau ʻo RSV i waena o nā keiki ʻōpio a pālahalaha maʻalahi mai ke keiki a ke keiki.
• Mai puhi i loko o kou hale, kaʻa, a me nā wahi kokoke i kāu pēpē. Hoʻonui ka hōʻike ʻana i ka uahi paka i ka makaʻu o ka maʻi RSV.

Pono nā mākua o nā pēpē me BPD e hōʻalo i ka lehulehu i ka wā o ka pā ʻana o RSV. Hōʻike pinepine ʻia nā laha e nā nūhou nūhou kūloko.

Kauoha paha kāu mea hāʻawi pēpē i ka lāʻau palivizumab (Synagis) e pale aku ai i ka maʻi RSV i kāu pēpē. E hāhai i nā ʻōkuhi pehea e hāʻawi ai i kāu pēpē i kēia lāʻau.

ʻOi aku ka maikaʻi o ka maikaʻi o nā pēpē me BPD i ka holo ʻana o ka manawa. Pono paha ka oxygen therapy i mau mahina. Loaʻa i kekahi mau pēpē i ka hōʻino lung lōʻihi a koi aku i ka oxygen a me ke kākoʻo hanu, e like me ka ventilator. ʻAʻole ola kekahi mau pēpē me kēia ʻano.

ʻOi aku ka makaʻu o nā pēpē i loaʻa iā BPD no nā maʻi hanu hou ʻana, e like me ka pulumonia, bronchiolitis, a me RSV e koi ai i kahi noho ma ka haukapila.

ʻO nā pilikia ʻē aʻe i loaʻa i nā pēpē i loaʻa iā BPD:

• Nā pilikia ulu
• Piʻi maikaʻi ʻole
• Pulmonary hypertension (ke koko kiʻekiʻe ma nā aʻa o nā akemāmā)
• ʻO nā pilikia loloa a me nā hanu manawa lōʻihi e like me ka scarring a i ʻole bronchiectasis

Inā loaʻa i kāu pēpē ka BPD, e nānā no nā pilikia hanu. Kāhea i ka hāʻawi o kāu keiki inā ʻike ʻoe i nā hōʻailona o ka maʻi hanu.

I mea e pale aku ai iā BPD:

• E kāohi i ka lawe ʻana ma mua ke hiki ke hiki. Inā hāpai ʻoe a noʻonoʻo paha e pili ana i ka hāpai ʻana, e mālama i ka mālama prenatal e kōkua i ka olakino a me kāu pēpē.
• Inā aia kāu pēpē i ke kākoʻo hanu, e nīnau i ka mea hāʻawi i ka manawa e hiki ai ke kāwili ʻia kāu pēpē mai ka ʻea.
• Loaʻa paha i kāu pēpē ka surfactant e kōkua i ka hāmama o nā māmā.

BPD; Maʻi maʻi maʻi mau loa - keiki; CLD - nā keiki

Kamath-Rayne BD, Jobe AH. Hoʻonui a me ka surfactant lung fetal. I: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. ʻO Medicine a Maternal-Fetal a Creasy a me Resnik: Nā Manaʻo a me ka Hoʻomeheu. 8th ed. Piladelapia, PA: Elsevier; 2019: chap 16.

ʻO McGrath-Morrow SA, Collaco JM. ʻO ka displasia Bronchopulmonary. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 20 ouk. Piladelapia, PA: Elsevier; 2020: chap 444.

ʻO Roosevelt GE. ʻO nā ʻōnaehana hanu pēpē Pediatric: nā maʻi o nā akemāmā. I: Nā paia RM, Hockberger RS, Gausche-Hill M, nā ʻaoʻao. ʻO Rosen's Emergency Medicine: Nā Manaʻo Manaʻo a me ka hana lapaʻau. 9th ed. Piladelapia, PA: Elsevier; 2018: chap 169.