Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0029713 (immaturity)
 4,335 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective study of 299 successive infants who were ventilated for respiratory distress syndrome (RDS) showed that 62 (21%) developed radiographic stage VI bronchopulmonary dysplasia (BPD). The largest, most mature, and least ill infants tended to survive without developing BPD; the smallest, least mature, and most ill infants tended to die without developing BPD. The patients who developed BPD tended to be intermediate in terms of weight, maturity, and severity of disease; they required longer exposures to elevated oxygen and assisted ventilation than patients who did not develop BPD. The data suggest that in addition to varying individual susceptibility (primarily degree of immaturity and initial severity of disease), elevated oxygen is more important than mechanical ventilation in the pathogenesis of BPD.
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PMID:Twelve years' experience with bronchopulmonary dysplasia. 86 36

The immaturity of the lung of the very prematurely delivered newborn appears to make it hypersusceptible to injury by those very therapeutic measures that the infant requires shortly after birth--mechanical ventilation and hyperoxia. There is good experimental evidence to relate the immature lung's susceptibility to early hyperoxia-induced lung damage to deficient antioxidant defensive systems. Less than fully adequate nutritional support of these tiny newborns can have extremely detrimental effects on their lungs' ability to resist and repair on-going injury and to continue developing normally. Promising experimental means of possible protection from hyperoxic lung damage and progression to chronic lung disease (bronchopulmonary dysplasia) are reviewed.
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PMID:Antioxidants, nutrition, and bronchopulmonary dysplasia. 152 71

The pathogenesis of NC in VLBW infants appears to be multifactorial. The vulnerability of extreme immaturity and the underdevelopment of renal function may be the most important variables. In some ways, we view this problem as similar to that of retinopathy of prematurity. (Clearly the exposure of the retina to high partial pressures of oxygen contributes to the development of retinopathy of prematurity but other variables--some known, such as an immature retina, and others not yet defined--must be present.) Hypercalciuria is common in the VLBW infant, yet not all develop NC. Decreased glomerular filtration rate, low citrate excretion, and frequently an alkaline urine are in part due to the immaturity of renal function of these infants. The need for prolonged hyperalimentation resulting in increased oxalate excretion and the development of BPD frequently requiring diuretics that may cause phosphaturia and magnesium depletion and that may increase calcium excretion are more common in the smallest and sickest of premature infants. Even transient insults to the kidneys, such as hypoxia or hypotension or the use of nephrotoxic drugs that provoke tubular injury and cell death with the probability of crystal formation and growth by way of heterogeneous nucleation, are likely to occur more frequently in this vulnerable population.
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PMID:Nephrocalcinosis. 157 67

To test whether the presence of airway inflammatory markers differentiated babies with hyaline membrane disease (HMD) who recovered (n = 18) from those in whom bronchopulmonary dysplasia (BPD) developed (n = 18), tracheal aspirate samples from 36 newborn infants with HMD who underwent intubation were collected during days 1 to 28 of life and analyzed for the mucosal antimicrobial proteins lactoferrin and lysozyme. For babies with HMD in whom BPD developed, lactoferrin concentrations were decreased during the first 4 days of life (7 +/- 3, 14 +/- 3, 18 +/- 3, and 18 +/- 3 micrograms/ml, respectively) in comparison with those in babies with HMD who recovered (23 +/- 8, 29 +/- 6, 41 +/- 9, and 81 +/- 19 micrograms/ml); group differences reached statistical significance on days 3 and 4 (p less than 0.05). Lysozyme levels in the secretions of babies with BPD were also lower on day 3 (31 +/- 5 micrograms/ml) than in those of babies who recovered (54 +/- 7.5 micrograms/ml). For babies with BPD whose endotracheal tube remained in place beyond day 4, lysozyme levels on days 5 to 12 were significantly lower for those classified as having severe BPD than for those with mild to moderate BPD. Because lysozyme and lactoferrin are products of serous cells found in submucous glands, it seems possible that the relative immaturity of submucous glands may influence the development of BPD.
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PMID:Lactoferrin and lysozyme deficiency in airway secretions: association with the development of bronchopulmonary dysplasia. 164 Feb 95

Continuous positive airway pressure (CPAP) administered as a mixture of oxygen and compressed air via nasal prongs has dramatically improved survival rates and lessened the frequency of barotrauma and bronchopulmonary dysplasia in the premature infant with respiratory distress syndrome. Associated with the increased use of nasal CPAP has been the development of marked bowel distension (CPAP belly syndrome), which occurs as the infant's respiratory status improves and the baby becomes more vigorous. To identify contributing factors, we prospectively compared 25 premature infants treated with nasal CPAP with 29 premature infants not treated with nasal CPAP. Infants were followed up for development of distension, defined clinically as bulging flanks, increased abdominal girth, and visibly dilated intestinal loops. We evaluated birth weight, weight at time of distension, method of feeding (oral, orogastric tube), and treatment with nasal CPAP and correlated these factors with radiologic findings. Of the infants who received nasal CPAP therapy, gaseous bowel distension developed in 83% (10/12) of infants weighing less than 1000 g, but in only 14% (2/14) of those weighing at least 1000 g. Only 10% (3/29) of infants not treated with nasal CPAP had distension, and all three weighed less than 1000 g. Presence of sepsis and method of feeding did not correlate with occurrence of distension. Neither necrotizing enterocolitis nor bowel obstruction developed in any of the patients with a diagnosis of CPAP belly syndrome. Our study shows that nasal CPAP, aerophagia, and immaturity of bowel motility in very small infants were the major contributors to the development of benign gaseous bowel distension.
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PMID:Benign gaseous distension of the bowel in premature infants treated with nasal continuous airway pressure: a study of contributing factors. 172 37

Respiratory adaptation during sleep improves with growth. The most vulnerable period for respiratory adaptation to sleep is from birth to 3 months of age. Factors that favor vulnerability are immaturity in ventilatory control and high rib cage compliance which impairs its effectiveness for ventilation. Improvement in respiratory adaptation during sleep is rapid during the first year of life. Sleep, and especially active (REM) sleep, is a risk period for respiratory disturbances in infants. Numerous factors may trigger apparent life threatening events. Respiratory disorders such as bronchiolitis, upper airway obstruction, and bronchopulmonary dysplasia impair respiratory adaptation during sleep. Treatment of respiratory disorders in infants must take into account the exacerbation of respiratory disturbances during sleep.
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PMID:Respiratory adaptation during sleep in infants. 211 10

A cohort of 678 consecutive very low birth weight infants, liveborn in one tertiary institution during a 63-month period, was studied to investigate whether antenatal steroid therapy had any beneficial or harmful effects on mortality or morbidity over the first 2 years of life. Comparing the 244 babies who received treatment with the 434 controls, 195 (79.9%) and 265 (61.1%), respectively, were discharged home (P less than 0.001). Mortality in the treated group remained substantially lower and was almost halved after adjustment for birth weight, extreme immaturity, lethal malformations, and confounding obstetric variables (P = 0.001). Fatal cases of respiratory distress syndrome were less common in the treated group (P = 0.044). Of in-hospital survivors, those in the treated group required less positive pressure respiratory support (P = 0.003) and fewer days in oxygen (P = 0.018), and the incidences of bronchopulmonary dysplasia (P = 0.003) and patent ductus arteriosus (P = 0.002) were lower. Two-year survivors who had received treatment were heavier (P = 0.016) and had larger head circumferences (P = 0.029). These beneficial associations in the treated group were not at the expense of increased rates of infection or adverse neurologic outcome. We did not detect any adverse effects of antenatal steroid therapy on any relevant aspect of mortality or morbidity in infancy under circumstances in which the chances of finding substantial differences were high.
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PMID:Effects of antenatal steroid therapy on mortality and morbidity in very low birth weight infants. 241 90

The improved techniques of medical care and reanimation of newborns have caused a relevant increase in the survival of those with a very low weight at their birth. Pathologies related both to the tissue immaturity of the patients treated and to the exceptionally strong technic of reanimation have increased: the bronchopulmonary dysplasia described by Northway and Coll. in 1967 is one of them. This work aims at examining the latest acquisitions of the syndrome, which in its early stages is still indistinguished from serious cases of HMD. The most efficient treatments applied are explained and prevention is stressed as the best therapy. The A. concludes that the reanimation therapy and the respiratory assistance should be carefully monitorized and there should be a close relationship between the neonatologist and the anaesthesiologist.
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PMID:[Recent findings on the subject of bronchopulmonary dysplasia]. 306 32

The major fetal risk associated with elective delivery is unexpected fetal lung immaturity and the development of hyaline membrane disease soon after birth. Prior to elective vaginal or abdominal delivery it has become standard obstetric practice to predict fetal lung maturity by the analysis of amniotic fluid obtained by amniocentesis or vaginal pool sample following preterm rupture of membranes. A correlation between third-trimester fetal biparietal diameter and the lecithin/sphingomyelin (L/S) ratio has been established by several investigators. In order to determine if a threshold BPD could be consistently correlated with fetal lung maturity, we retrospectively examined the hospital and laboratory records of a group of 115 nondiabetic parturients in whom BPD measurements and amniotic fluid analysis for L/S ratio had been performed for various clinical indications. A threshold BPD of greater than or equal to 9.2 cm in all parturients who underwent elective repeat cesarean delivery was associated with no hyaline membrane disease (HMD). Two of the three neonates who developed HMD had mature L/S ratios but were products of pregnancies complicated by third-trimester hemorrhage. A review of our present data suggests that about one-third of clinically-indicated amniocenteses in the absence of maternal diabetes or third-trimester hemorrhage could potentially be avoided without adverse neonatal impact. Possible therapeutic application of this finding requires further prospective study.
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PMID:Third-trimester biparietal diameter as a predictor of fetal lung maturity. 330 Jun 78

The free radical theory of O2 toxicity provides a testable explanation of the mechanism of O2's toxic effects on a biochemical and cellular level. In addition, it provides for an understanding of the array of normal antioxidant defenses of the cell and an insight to rational approaches to pharmacologic prophylaxis against clinical O2 toxicity. Neonatal animals of many species are much more resistant to the lethal effects of exposure to high concentrations of O2 than are the adult animals of the species; this increased tolerance is associated with the newborn lungs' ability to increase its normal complement of protective antioxidant enzymes during O2 exposure. Premature infants who require vigorous hyperoxic respiratory support early in life frequently develop acute and chronic lung changes compatible with pulmonary O2 toxicity, so-called bronchopulmonary dysplasia. The lung of the prematurely born may be quite ill-adapted for protecting itself against hyperoxic exposure owing to immaturity of its antioxidant defensive systems. Clinical pharmacologic stratagems designed to augment the intracellular antioxidant defensive capacity of the lung may become available in the near future, which would provide some means to prevent or ameliorate the serious lung damage associated with the clinical use of life-giving O2.
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PMID:Effects of oxygen on the newborn. 388 88


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