Synopsis: In the 2nd episode in our 3-Part Series on Ways to Attack Pulmonary Vascular Disease, Lucile Packard Children’s Hospital Drs. Shazia Bhombal, Mike Tracy, and Rachel Hopper, who developed the multidisciplinary Cardiac and Respiratory Care for Infants with BPD also known as neonatal chronic lung disease, discuss Stanford’s CRIB program and Covid-19. @StanfordChild Rachel Hopper, MD Michael Tracy, MD Shazia Bhombal, MD Host: Welcome to the PH at Stanford Podcast. This new podcast series comes to you from the Vera Moulton Wall Center for Pulmonary Vascular Disease at Stanford, with the goal to eradicate pulmonary vascular disease by discovering fundamental causes, developing innovative therapies, disseminating crucial knowledge, and delivering transformative care. Today, is the 2nd in a three-part COVID-related series on Ways to Attack Pulmonary Vascular Disease. Lucile Packard Children’s Hospital Drs. Shazia Bhombal, Mike Tracy and Rachel Hopper, who developed the multidisciplinary Cardiac and Respiratory Care Program for Infants with BPD also known as neonatal chronic lung disease, discuss Stanford’s CRIB program and Covid-19. Rachel Hopper, MD: My name is Rachel Hopper, I'm a pediatric cardiologist and pulmonary hypertension specialist at Stanford Children's Hospital, and co-director of the CRIB team. Michael Tracy, MD: Hi, my name is Michael Tracy, I'm a pediatric pulmonologist at Stanford Children's Hospital, and I am a co-director of the CRIB team. Shazia Bhombal, MD: Hi, my name is Shazia Bhombal, I'm a neonatologist and cardiologist at Stanford Children's Hospital, and I'm co-director of the CRIB team. We're really excited to talk to you all today about our CRIB program at Stanford Children's Hospital. And give you a little description to talk about prematurity, chronic lung disease and pulmonary hypertension. So, to start off we'll talk a little bit about prematurity. Babies generally need about 40 weeks to mature and be ready for being born. A premature baby is a baby born more than three weeks before their due date. In the U.S., about one in 10 babies are born preterm. In general, premature babies have more health problems and longer hospitalizations than babies born full term. Babies who are born preterm may not be fully developed at birth, and some need to spend time in the hospital after birth, in the neonatal intensive care unit for additional medical care, such as helping with breathing, feeding, and maintaining temperature. With advances in medical care babies are surviving earlier and earlier. Some babies in the hospital for days, weeks, some for months or even longer as they gain weight and learn to keep warm without help from the incubator, and learn to feed and breathe. Some may need to go home with special medical equipment, and will have continued close follow-up as they leave the hospital. One major complication of extreme prematurity is chronic lung disease, also called bronchopulmonary dysplasia (BPD). Baby's lungs continue and develop and grow during the pregnancy, so when they're born early, their lungs may be underdeveloped. The higher risk of this can occur the earlier that they are born. In the United States, BPD impacts about 10,000 - 15,000 infants per year, and is diagnosed in about half of all infants weighing less than about two pounds at birth. Up to a quarter of these infants with BPD will develop pulmonary hypertension, or high blood pressure in the lungs. This causes extra work for the right side of the heart, as it pumps into the higher pressure of the lungs. And if untreated can cause heart failure and even death. Early diagnosis and treatment of pulmonary hypertension are important, as many patients respond well to therapies. Dr. Tracy and Dr. Hopper will explain more about lung disease and heart issues that can come up in premature babies. Michael Tracy, MD: So moving forward in talking more about what is BPD, bronchopulmonary dysplasia, again is a term used to describe long-term breathing problems in premature babies. It involves abnormal development of the lungs and in the most severe cases, the lungs can become scarred and inflamed. BPD was first defined at Stanford in 1967, though has changed substantially over the years. In particular the development of surfactant, which was administered to premature babies along with improved ventilators has very much changed this population and allowed younger premature infants to survive. The BPD we see now, again, develop some premature babies with underdeveloped lungs. It can also be called chronic lung disease or neonatal chronic lung disease. In the term bronchopulmonary, broncho refers to the airways, the bronchial tubes through which the oxygen breathe travels into the lungs and then pulmonary refers to the lungs, tiny air sacks or alveoli, where oxygen and carbon dioxide are exchanged. Dysplasia, means abnormal changes in the structure or organization of a group of cells. And the cell ...
