Infants with CLD have longer hospital stays, increased re-hospitalizations, more
pulmonary hypertension, higher rate of neurologic impairment, higher incidence of poor
growth, and increased risk of mortality.
Early Xray findings include diffuse haziness and a ground glass appearance. Later, the
film may show pulmonary edema, airway cuffing, atelectasis, cystic changes, and air
trapping.
Treatment / Management of CLD
The best way to manage CLD is to prevent or minimize it. The time on a ventilator
should be decreased as much as possible. There should be a conscious effort to
minimize the pressure and oxygen levels. Enhancement of growth of normal lung tissue
is accomplished in the absence of a ventilator and excess oxygen. This means
aggressive weaning and extubations of the infant to CPAP or nasal cannula as soon as
possible, accepting higher pCO2s (50-60mmHg) and lower oxygen saturations (89-
95%).
Other therapies for CLD used acutely and chronically, are steroids, diuretics, and beta
agonists, but have not shown to be universally beneficial. Again, lung protective
therapies such as avoidance of infection, ventilation and hyperoxia, as well as ensuring
good nutrition are critical to long-term growth.