![]() ![]() Several studies have shown persistent elevation of neutrophils, alveolar macrophages and high concentrations of lipid mediators in the tracheal effluent from infants with CLD. ![]() Although barotrauma and oxygen toxicity may directly injure the immature lung, recruitment and activation of inflammatory cells may potentiate lung damage and impaired healing. The most important factors that have been implicated, directly or indirectly, are prematurity, barotrauma, oxygen toxicity, inflammation and infection. ![]() The specific mechanism(s) that lead to CLD have not been clearly defined, but it is likely that multiple factors contribute to the disease. No therapeutic study published to date has demonstrated any single medication or combination of medication that improves survival or dramatically decreases severity or duration of illness. Current therapies for CLD, many with demonstrated short-term but not long-term efficacy, include diuretics, bronchodilators, and corticosteroids. Despite recent advances in neonatal care the incidence of CLD has not decreased, likely due to the survival of smaller more immature infants. Mortality rates for infants with CLD vary from 5% to 30%. Between 3,000 and 7,000 infants develop CLD per year in the United States.
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