Chronische longziekte van de pasgeborene; pathofysiologie en behandeling na de eerste levensweken

- Chronic lung disease of the neonate sometimes occurs as a residual condition following respiratory distress in preterm infants.

- Improvements in neonatal intensive care treatment will in future lead to a greater number of children surviving chronic lung disease and reaching adulthood.

- The symptoms of the disease are hypoxaemia, hypercapnia, tachypnoea, subcostal and intercostal retractions, fluid retention, a reduced exertion tolerance and hyperreactive airways.

- The treatment after the first weeks of life is symptomatic and consists of:

- providing supplemental oxygen via a nasal mask or cannula (0,1-1 l/min); rapid downward adjustment of oxygen therapy may lead to more complaints and poorer growth;

- a normal fluid therapy; if there is a tendency towards fluid retention, then diuretic therapy is indicated and in severe cases fluid restriction as well;

- in the case of bronchial hyperreactivity: inhaled corticosteroids (the lowest effective dose for a period of several months) and a trial treatment with beta-agonists; in the case of persistent complaints or functional limitations, lung function tests can distinguish obstructive and restrictive disorders;

- vaccinations according to the national programme; consider vaccinations against influenza (age: 6-12 months) and respiratory syncytial virus (age < 2 years).