Diffuse alveolar damage and chronic lung disease

Diffuse alveolar damage (DAD) is characterized by an increase in alveolar-capillary permeability and an active inflammatory response in the immature lung caused by oxygen toxicity, ventilator-related injury, infection, patent ductus arteriosus (PDA) or some combination of these factors. The resultant changes in lung compliance increase the need for mechanical ventilation and supplemental oxygen that could contribute to the development of persistent lung injury. Thus, DAD could represent the initial phase of Chronic Lung Disease (CLD). The purpose of this study is to describe the risk factors for DAD and its relationship with CLD. We included 165 neonates. 20 of 165 (12%) developed DAD and were treated with Dexamethasone. Risk or associated factors are: extremely low birth weight (ELBW) and gestational age (GA), male gender, respiratory distress syndrome (RDS) severity and congenital pneumonia (CP), especially due to Ureaplasma Urealyticum. Dexamethasone therapy might possibly prevent the evolution of DAD into CLD as this complication is observed in only 40 % of the treated patients.