The purpose of the evidence-based case study article was to determine the relationship between bronchopulmonary dysplasia and gestational age. The study drew samples from preterm infants of 24-30 weeks in the period between the first day of 2009 and the last day of 2013. Researchers in the study then subjected the samples to tests and analysis to determine their risk levels to bronchopulmonary dysplasia. Fundamentally, bronchopulmonary dysplasia (BPD) is a disease that commonly affects newborns, leading to high rates of infant mortality. The disease is associated with birth weight and gestational age. BPD is characterized by arrested alveolar development that has a reduced number but an increased size of alveoli, as well as impaired capillaries. Such conditions on alveoli are significantly the major respiratory problem of the preterm birth in the current population. Other factors that lead to the development of BPD are small gestation age (SGA), and appropriate for gestation age (AGA). Studies show that SGA is the main risk factor of BPD in preterm infants than AGA newborns. Ideally, the primary cause of SGA is a condition known as preeclampsia. The disease also causes BPD and premature birth of the infants.
According to researches, BPD also results in low-weight births. Also, newborns exhibit more cases of SGA than AGA. Essentially, the disparity is due to a pandemic disease called preeclampsia, which develops when a child is born to a mother suffering from gestational hypertension. As Bancalari, et al. (2019) argue, gestational hypertension affects 2% to 8% of pregnancies. Again, since preeclampsia affects pregnancies, it sometimes causes BPD, thereby impacting premature births. Such births make newborns have underweight, and platelets count can also so become low (Wright & Kirpalani, 2011). Therefore, as a nurse, there is a need to take care of a patient by knowing the kind of treatment of a diagnosed disease. Besides, infants of premature births should receive good care during by getting nursing and medication as doctors prescribe in cases of low respiratory defects as well as low platelets counts.
Critique of the Article
Researchers have carried out studies concerning preeclampsia as an antigenic state that causes the impairment of the lungs, leading to BPD and eventually low birth weight. However, no clear evidence shows how the two diseases relate to one another. For instance, studies show that preeclampsia leads to BPD, but authors of such studies do not elaborate on the practicability of the scenario (Wright & Kirpalani, 2011). Lack of support for the finding has consequently led to doubts on the study. Elsewhere, in the case of neonatal outcomes of newborns to mothers suffering from preeclampsia, just a few studies outline the analysis of the phenomenon. However, none of the studies analyze the consequences of BPD at 36 weeks of postmenstrual age (PMA). Thus, the research ignores information that is essential for the patients experiencing such defects to get solutions to their problems.
Based on the information the author of the article gives, there are different opinions of the researchers considering the studies based on SGA and AGA newborns. Some studies show that there is no critical difference between the two in terms of age (Mourani et al. 2015). However, infants born before the 28th week of gestation ought not to be included since the outcome can be either death or serious neonatal care. As such, the research shows critical information. Additionally, the article outlines a significant aspect of the increase in mortality in newborns of mothers who suffer from vascular disorders. The study in the article shows that babies born after pregnancies with vascular disorders, and register birth weight below the 10th percentile, are at a higher risk of BPD.
According to Torching's study, it is clear that in cases of vascular pregnancy disorders, restrictions on fetal growth cause preeclampsia, which leads to the development of BPD. Therefore, this confirms that for BPD to occur there must be the presence of preeclampsia, which comes as a result of gestational hypertension in mothers. The article, therefore, outlines the significance of preeclampsia disease to low birth weight as well as in the case of the development of the respiratory illness (BPD). Moreover, the author also gives significant information on the study of BPD. There is a higher risk of outcomes in SGA than in AGA in newborns, and more occurrences of respiratory morbidities for SGA cases than in AGA preterm infants (Dravet-Gouno et al., 2018). According to the findings from the research on bronchi pulmonary dysplasia, the data concerning the number of babies born to mothers with preeclampsia help in the getting the significance of birth weight for gestational age (GA) in the development of BPD. Thus, information from the research helps in knowing the causes of some defects in newborns along with problems associated with births. Therefore, I am in a better position to easily apply the information during my practice in the nursing environment.
How the Research Findings are Applicable in the Patient's Nursing Care
Bronchopulmonary dysplasia is a condition that often affects the infants owing to the use of ventilator of being in the oxygen machine for a considerable duration. Therefore, the findings of the article play a crucial role in nursing practice. The study establishes possible outcomes amongst the preterm neonates, thus, presenting evidence-based practice that is useful in the management of such neonates. Besides, nurses also utilize the evidence-based technique in the study in the use of noninvasive ventilation for the pre-term neonates. Such has been proved by the survey as a technique that helps to avoid complications that preterm neonates develop, including ventilation morbidity. Issuing systemic steroids is another evidence-based technique that is vital in the management of bronchopulmonary dysplasia, thus, improving the quality of life that individuals with such conditions lead. The evidence-based care that the study proposes has the primary intention of minimizing the pulmonary disease that the neonates could acquire.
Mechanical ventilation leads to bronchopulmonary dysplasia amongst the pre-term neonates. Therefore, the utilization of strategies such as continuous positive airway pressure and noninvasive ventilation has been proven as improving the health outcomes that patients are prone to experience. The use of the evidence-based practices has the potential of reducing lung injuries of the preterm neonates, thus, improving the quality of their life. Nurses need to enforce the evidence-based practice in their areas of work owing to the positive role that it would play in the improvement of the health outcomes of the patients. However, training is required on how such could be implemented to eliminate the likely incidence of clinical errors that could result from the process.
Bancalari, E., Claure, N., Jobe, A. H., & Laughon, M. M. (2019). Definitions and Diagnostic Criteria of Bronchopulmonary Dysplasia: Clinical and Research Implications. In The Newborn Lung (Pp. 115-129). Content Repository Only!.
Cheong, J. L., & Doyle, L. W. (2018, October). An Update on Pulmonary and Neurodevelopmental Outcomes of Bronchopulmonary Dysplasia. In Seminars in Perinatology. WB Saunders.
Dravet-Gounot, P., Torchin, H., Goffinet, F., Aubelle, M. S., El Ayoubi, M., Lefevre, C., & Zana-Taieb, E. (2018). Bronchopulmonary Dysplasia in Neonates Born to Mothers with Preeclampsia: Impact of Small for Gestational Age. Plos One, 13(9), E0204498.
Mourani, P. M., Sontag, M. K., Younoszai, A., Miller, J. I., Kinsella, J. P., Baker, C. D., & Abman, S. H. (2015). Early Pulmonary Vascular Disease in Preterm Infants at Risk for Bronchopulmonary Dysplasia. American Journal of Respiratory and Critical Care Medicine, 191(1), 87-95.
Wright, C. J., & Kirpalani, H. (2011). Targeting Inflammation To Prevent Bronchopulmonary Dysplasia: Can New Insights Be Translated Into Therapies?. Pediatrics, 128(1), 111-126.
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