Anemia of Prematurity - Portal Neonatal

Physical:
• Infants with BPD have abnormal findings on physical examination, chest radiography,
pulmonary function testing, and histopathologic examination.
• Infants with severe BPD are often extremely immature and of very low birth weight.
o They frequently respond to conventional ventilation and surfactant administration.
o Extraordinary therapeutic modalities, such as HFV and inhaled NO, have been
employed to improve survival of these infants with mixed success.
o Oxygen and ventilator requirements often increase within the first 2 weeks of life.
• Other infants initially respond well to surfactant and various forms of ventilation strategies.
o Over the course of the second to fourth weeks of life, oxygen assistance, ventilator
assistance, or both often increases to maintain adequate oxygenation and
ventilation.
o Chest radiographs obtained in these infants may demonstrate decreased lung
volumes, areas of atelectasis and hyperinflation, lung haziness, and PIE.
• Arterial blood gases may reveal acidosis, hypercarbia, and hyperoxia.
• Physical examination may reveal the following:
o Tachypnea
o Tachycardia
o Increased work of breathing, with retractions, nasal flaring, and grunting
• Poor weight gain and increased energy intake requirements are frequently noted.
• Different scoring systems have been developed and studied to predict BPD, to gauge the
severity of illness, and to predict the survival of patients with BPD.
Causes: See History for a detailed discussion of the following causes.
• Volutrauma and barotrauma
• Oxygen toxicity
• Inflammation
• Infection
• Nutrition
DIFFERENTIALS Section 4 of 11
Atelectasis, Pulmonary
Hypertension
Patent Ductus Arteriosus
Pneumonia
Subglottic Stenosis
Tracheomalacia
Other Problems to be Considered:
Airway injury