Article

Displasia broncopulmonar y prematuridad: Evolución respiratoria a corto y a largo plazo

Sección de Neumología Infantil, Hospital Universitario Virgen Macarena, Sevilla, España
Anales de Pediatría (Impact Factor: 0.83). 01/2010; 72(1). DOI: 10.1016/j.anpedi.2009.09.010
Source: OAI

ABSTRACT

La displasia broncopulmonar (DBP) es la enfermedad pulmonar crónica más frecuente en niños prematuros. Con la introducción de corticoides prenatales, la administración de agente tensioactivo y las nuevas estrategias de ventilación mecánica, se ha incrementado la supervivencia de neonatos cada vez más inmaduros, por lo que la incidencia de la DBP no sólo no ha descendido, sino que ha aumentado en este grupo de niños nacidos extremadamente pretérmino. Condiciona una gran morbilidad respiratoria en los 2�3 primeros años de vida, con numerosos ingresos hospitalarios y agudizaciones respiratorias provocados en su mayoría por infecciones víricas. Aunque hay una tendencia hacia la mejoría, en la edad escolar y la adolescencia persisten los síntomas respiratorios, así como alteraciones en la función pulmonar, y con cierta frecuencia estos niños presentan menor capacidad para el ejercicio. Aunque los síntomas de la DBP son muy parecidos a los del asma, ya que existe limitación al flujo aéreo e hiperrespuesta bronquial (HRB), el mecanismo fisiopatológico podría ser distinto en las 2 enfermedades. Por otra parte, la prematuridad aislada desempeña un papel importante en la enfermedad respiratoria crónica del niño y ya desde los primeros meses de vida se demuestran alteraciones en la función pulmonar de niños pretérmino sanos. Se ha observado que estos niños también tienen mayor morbilidad respiratoria que los nacidos a término no sólo en los primeros años de vida, sino en edades posteriores. En este artículo analizaremos distintos aspectos de la enfermedad respiratoria crónica asociada a la prematuridad, deteniéndonos en la sintomatología clínica, las alteraciones de la función pulmonar, la HRB y la capacidad de ejercicio. Haremos un recorrido desde la primera infancia hasta la adolescencia y la edad adulta joven. También veremos las similitudes y las diferencias entre la DBP y el asma.

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