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Chronic Lung Disease in Children PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Chronic Lung Disease in Children" by Dr Sarika Gupta (MD,PhD).

This medical PowerPoint presentation is about chronic lung disease in children, a group of conditions that affect the lungs and airways, causing long-term breathing difficulties. These conditions are characterized by inflammation, scarring, and narrowing of the airways, which can lead to symptoms such as coughing, wheezing, shortness of breath, and chest tightness.

The most common types of chronic lung disease in children include asthma, cystic fibrosis, bronchopulmonary dysplasia, and bronchiectasis.

Asthma is a chronic condition that causes the airways to become inflamed and narrow, making it difficult to breathe. Symptoms can be triggered by a variety of factors, including allergens, exercise, and respiratory infections.

Cystic fibrosis is a genetic disorder that affects the lungs, digestive system, and other organs. It causes a buildup of thick mucus in the lungs, which can lead to infections and breathing difficulties.

Bronchopulmonary dysplasia is a lung disease that primarily affects premature infants who require mechanical ventilation or oxygen therapy. It can cause scarring and inflammation in the lungs, leading to breathing problems and other complications.

Bronchiectasis is a condition in which the airways become abnormally widened and scarred, making it difficult to clear mucus from the lungs. It can be caused by repeated respiratory infections, immune disorders, or other underlying conditions.

Treatment for chronic lung disease in children typically involves a combination of medications, such as bronchodilators and steroids, as well as breathing exercises and lifestyle modifications. In some cases, surgery may be necessary to improve lung function or remove damaged tissue.

Its important for parents and caregivers to work closely with their childs healthcare provider to manage their chronic lung disease and minimize the risk of complications. With proper treatment and management, many children with chronic lung disease can lead full and active lives.

Tags : Chronic Lung Disease in Children, breathing difficulties, coughing, wheezing, shortness of breath, chest tightness, asthma, cystic fibrosis, bronchopulmonary dysplasia, bronchiectasis, Pediatrics, Pediatrics PowerPoint presentation

Published on : Jun 23, 2023 | Views : 2724 | Downloads : 0

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Slide 1-

Chronic Lung Disease in Children Dr Sarika Gupta (MD,PhD); Asst. Professor
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Chronic Lung Disease in Children Cough, wheeze and dyspnoea Chest deformity Stunting and failure to thrive Clubbing Halitosis Sputum production Cyanosis Cor pulmonale
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Chronic Lung Disease in ChildrenPatterns of Onset Chronic symptoms and signs from birth Anatomical and developmental disorders T-O Fistulae Laryngo/tracheo/bronchomalacia Lung cysts/ dysplasia Congenital lobar emphysema Diaphragmatic hernia Persisting disease after neonatal resp distress BPD (Chronic lung disease of infancy)
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Chronic Lung Disease in ChildrenPatterns of Onset Chronic symptoms and signs with insidious onset after normal early life Immune-mediated disorders Asthma Interstitial disorders Immune deficiency disorders Chronic or recurrent infection Infections per se Tuberculosis
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Chronic Lung Disease in ChildrenPatterns of Onset Chronic symptoms and signs after acute onset Acute non-febrile onset Foreign body Inhalation injury (paraffin, smoke) Acute febrile onset Bronchiolitis obliterans Necrotising pneumonia
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Chronic Lung Disease in ChildrenDisease Patterns Relapsing symptoms with periods of apparent normality Reactive airways eg asthma Exacerbations of symptoms without normality in between Episodes of febrile deterioration Super-imposed infection on Abnormal lung/bronchiectasis Foreign body Uncontrolled asthma with acute attacks Chronic persistent symptoms Cough, wheeze
Slide 8-

Chronic lung disease : clinical categories Obstructive lung disease Mainly airway obstruction with air trapping : XRay shows high lung volume Restrictive lung disease Low lung volume, lung cannot expand Destructive lung disease Usually associated with infection and pus formation
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Cystic fibrosis Autosomal recessive Chronic respiratory symptoms Cough Recurring pneumonia Chronic URTI Chronic airway obstruction Bronchiectasis Pancreatic deficiency and malabsorption Diagnosis: Sweat ChlorideTest, Gene Probe Δ508, 72 hr. fecal fat determination, fasting blood sugar, liver function studies, sputum culture, X Ray chest
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Cystic fibrosis Factor responsible for manifestations of the disease is mechanical obstruction caused by increased viscosity of mucous gland secretions Mucous glands produce a thick protein that accumulates and dilates the glands Passages in organs such as the PANCREAS become obstructed First manifestation is meconium ileus in newborn
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Cystic fibrosis Respiratory goal: removal of secretions (chest physiotherapy with Thairapy vest) by vibrations loosen mucus Nutritional: Fat soluble vitamins ADKE High calorie, high protein, low fat Maintain Na balance (when sweating and ill)
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Bronchiectasis Permanent destruction of bronchial wall and lung tissue due to chronic infection : Lumen obstruction eg foreign body, lymph nodes Parenchymal destruction from pneumonia with tissue necrosis Repeated respiratory infections with Cystic Fibrosis, malnutrition, HIV, recurrent aspiration
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Bronchiectasis Repeatedly ill with febrile chest infections Clubbing and halitosis Discoloured sputum Widespread crackles and wheezes Progressive deterioration of lung function Development of pulmonary hypertension Management : Physiotherapy, antibiotics, bronchodilators, immunize against “flu”, surgery in localized unilateral disease with good lung function
Slide 14-

Chronic wheezing Splinting of upper limb girdle Barrel chest Air trapping on X Ray Causes: Asthma Bronchiolitis obliterans HIV-associated lung disease
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Bronchopulmonary Dysplasia DEFINITION: defined as a need for increased oxygen: • Infants <32 weeks gestation: oxygen requirement at 36 weeks gestational age or at discharge (whichever comes first) • Infants ≥32 weeks gestation: oxygen requirement at age >28 d or at discharge (whichever comes first) INCIDENCE is inversely related to birth weight and GA
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Bronchopulmonary Dysplasia ETIOLOGICAL FACTORS include: • Lung immaturity with (a) ↑ susceptibility to damage from oxygen, barotrauma and volutrauma, (b) surfactant deficiency and (c) immature antioxidant defenses • Oxygen toxicity • Barotrauma and volutrauma • Pulmonary edema (excessive fluid administration, patent ductus arteriosus) • Inflammation (multiple associated biochemical changes)
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Bronchopulmonary Dysplasia CLINICAL FEATURES: • Hypoxia due to V/Q mismatch • ↑ work of breathing • Abnormal chest radiograph • ↑ airway resistance is late feature • Pulmonary hypertension • Cor pulmonale (late)
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Bronchopulmonary Dysplasia PREVENTIVE MEASURES: • Minimize barotrauma & volutrauma • Minimize oxygen toxicity • Careful attention to intake of fluid and Na+ TREATMENT of ESTABLISHED CLD: Adequate caloric intake After 36 weeks GA, maintain O2 saturation >95% Restrict intake of fluid and Na+ Diuretics Bronchodilators Steroids are almost never indicated Infection prevention
Slide 19-

Interstitial lung disease Interstitial lung disease consists of a diverse group of disorders that involve the pulmonary parenchyma and interfere with gas exchange "diffuse parenchymal lung disease" or “diffuse lung disease” ILD is rare in childhood Children with ILD may present with respiratory failure, or with more indolent or chronic symptoms including tachypnea, hypoxemia, retractions, cough, exercise intolerance, failure to thrive, gastroesophageal reflux
Slide 20-

Interstitial lung disease ILD should be considered in any neonate who presents with unexplained respiratory failure, or in infants and children with a normal birth history who present with persistent tachypnea, crackles, hypoxemia, chronic cough, or clubbing of the digits ILD should also be considered in late preterm or preterm infants who present with chronic lung disease out of proportion to the degree of prematurity or other known comorbidities
Slide 21-

Interstitial lung disease Diagnostic studies in children with suspected interstitial lung disease To exclude more common causes of chronic respiratory symptoms: Sweat chloride testing Evaluation for gastroesophageal reflux and recurrent aspiration (such as barium swallow, pH/impedance probe and others) Bronchoscopy Cultures and testing for infectious etiologies Echocardiogram Testing for HIV and other immunodeficiencies
Slide 22-

Interstitial lung disease Diagnostic studies in children with suspected interstitial lung disease to assess extent and severity of disease: Chest radiographs Chest computed tomography scan Electrocardiogram/ Echocardiogram Pulmonary function studies
Slide 23-

Interstitial lung disease Diagnostic studies in children with suspected interstitial lung disease to identify systemic disorders predisposing to interstitial lung disease: Immune studies - Immunodeficiency/immune dysfunction Studies for connective tissue disease-ANA, ANCA (Autoimmune disease, Sarcoidosis, Vasculitis syndromes including granulomatosis with polyangiitis [Wegener's], Anti-glomerular basement membrane disease) Hypersensitivity pneumonitis panel Serum and urine amino acids Genetic studies for surfactant dysfunction
Slide 24-

Interstitial lung disease TREATMENT — supportive therapy and pharmacologic interventions, tailored to the type of ILD: Supportive therapy Limiting exposure to cigarette smoke and other inhaled irritants Oxygen therapy for hypoxemia Supervised exercise Bronchodilators for reversible airway obstruction Aggressive treatment of intercurrent infections Standard childhood vaccinations RSV Immunoprophylaxis
Slide 25-

Interstitial lung disease Specific treatment — Specific treatment is available for some ILD disorders Antimicrobials for certain infections, management of swallowing dysfunction and/or reflux in patients with chronic aspiration, avoidance of the offending antigen in hypersensitivity pneumonitis, and whole lung lavage for older children with pulmonary alveolar proteinosis Glucocorticoids are the mainstay of therapy for many children with ILD because inflammation and inappropriate cellular proliferation are thought to play an important role in pathogenesis of many ILD subtypes Lung transplantation
Slide 26-

Chronic lung disease : Management In patients with long standing symptoms consider the possibility of chronic lung disease rather than just prescribing antibiotic treatment Diagnosis : XRay, TB skin test, special studies-sweat test, CT scan Functional assessment : Lung function, 02, CO2 Airway management: bronchodilator Specific therapy (anti-inflammatory) Antibiotic for infection and fever Physiotherapy : postural drainage Monitor for pulmonary hypertension and cor pulmonale
Slide 27-

Summary