Oxidants and Antioxidants: What Role Do They Play in Chronic Lung Disease?

The infant who is born prematurely must face multiple hardships, including those associated with shortened gestation, interrupted development, and dramatic environmental transition. Could Shakespeare have been aware of these adverse circumstances facing the premature infant when he described the prematurely born Richard II as ‘‘rudely stamped . . . deformed, unfinished, sent before my time into this breathing world ‘scarce’ made up’’? With incompletely developed antioxidant defenses and having been denied the final trimester’s acquisition of a number of crucial nutrients, the premature infant leaves behind the relatively hypoxic intrauterine environment and is forced to adapt to the relatively hyperoxic extrauterine environment. The immature antioxidant defenses coupled with an oxidant environment and nutritional inadequacies may play a crucial role in the development of chronic lung disease (CLD) in the preterm neonate

Nutritional Issues in Chronic Lung Disease of Premature Infants

Nutrition is important to the processes that are involved in normal lung development and maturation. Discussions of the etiologies of chronic lung disease (CLD) in premature infants, such as oxidant injury, barotrauma, infectious agents, and aberrant intrinsic processes, require inclusion of nutritional influences (1-3). Several reports have appeared in the literature concerning the influence of nutritional status and specific nutrients, including lipid, protein, vitamins, and trace minerals, on lung function, development, and repair (4-7). Despite credible evidence on the ability of nutrition to influence normal lung development and function and to effect a major influence on the tolerance of the lung to adverse extrinsic challenges, particularly oxidant injury, little definitive information exists on the influence of nutrition in modulating the outcome of CLD in the human infant. The purpose of this chapter is to present evidence supporting the hypothesis that nutrition, including specific nutrients, can modulate the outcome of CLD in human infants through alteration in susceptibility to oxygen toxicity. The chapter also identifies a number of relevant current controversies

Catheter-induced Aortic Thrombus Masquerading as Coarctation of the Aorta

The placement of an umbilical artery catheter is firmly established as an essential technique in the care of ill neonates. This simple procedure involves well recognized risks. Thrombotic complications are frequently seen with umbilical artery catheter (UAC) placement. The occurrence, however, of an aortic thrombus presenting as classical aortic coarctation has not been reported previously. This report describes two infants with classical symptomatology of coarctation of the aorta who were found instead to have aortic thrombus formation in association with umbilical artery catheter placement