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Revista de la Asociación Médica del Centro Médico ABC

2012, Número 3

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An Med Asoc Med Hosp ABC 2012; 57 (3)


Displasia broncopulmonar en el recién nacido pretérmino. Revisión bibliográfica

Duck HE, Cullen BPJ, Salgado RE, Guzmán CB

Idioma: Español
Referencias bibliográficas: 48
Paginas: 223-231
Archivo PDF: 72.32 Kb.


RESUMEN

La displasia broncopulmonar se define como la dependencia de oxígeno a los 28 días postnatales. Tiene una incidencia de 20 a 60% y son factores predisponentes la prematurez, el peso bajo al nacimiento, la persistencia del conducto arterioso y los procesos inflamatorios. En la lesión que se observaba en la era presurfactante, conocida como clásica, hay inflamación, hipertrofia de músculo liso y fibrosis; la lesión observada con los nuevos tratamientos se conoce como «nueva displasia» y tiene menos fibrosis pero más metaplasia y reducción de lecho vascular. La gravedad clínica de los pacientes con displasia se puede determinar por la frecuencia y dificultad respiratoria, los requerimientos de oxígeno y la tasa de crecimiento. El objetivo del tratamiento es reducir los síntomas disminuyendo el daño en tres etapas: prevención, tratamiento de la displasia en evolución y de la displasia establecida. Para lograr los objetivos se usan estrategias ventilatorias, terapia antioxidante, estrategia nutricional integral y otros medicamentos. Algunos pacientes se egresan con oxígeno y otros medicamentos pero no todos requieren monitor. Los pacientes con displasia tienden a hospitalizarse por infecciones respiratorias en los primeros dos años y suelen tener problemas para el crecimiento y el desarrollo.


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