Podcast-Chronic Lung Disease (CLD)

English
Credit (s)

Learning Objectives

At the end of this episode, participants should be able to:

  • Define what constitutes chronic lung disease
  • Understand how to approach management of children with CLD

Intended Audience:

This online course is designed for pediatricians, family physicians, Allergy specialists, pulmonologists and nurses, as well as other health care providers and managers.

Abstract:

In this episode, you will hear from Dr. Manvi about Chronic Lung Disease )CLD) and how to mange the children with CLD. Chronic lung disease (CLD) is a blanket term used to describe chronic pulmonary disorders resulting in ongoing inflammation and repair in setting of growth and development which is inadvertently affected by this process. CLD can for instance can be secondary to genetic abnormality that leads to ineffective airway clearance like in cystic fibrosis, primary ciliary dyskinesia, neuromuscular weakness, chronic aspiration, ventilator associated lung injury in setting of mechanical ventilation, prematurity, asthma, childhood interstitial lung diseases etc. Bronchopulmonary dysplasia (BPD) is CLD associated with prematurity that carries typical histological, or physiologic or clinical definition as defined in literature which has changed over the years. Infant previously described as having mild BPD before as per NIH definition may not carry label of BPD under newer BPD classification system. These children who are born premature but incur lung disease are grouped under post prematurity respiratory disease which also includes those who satisfy definition of BPD. Eventually diagnosis and management depend on the underlying pathophysiological process that is leading to CLD. Most important is always good history and examination which can help sort out this process followed by some help from laboratory testing, imaging, swallow evaluation if needed, breathing tests and flexible bronchoscopy etc. Once we understand pathophysiology, directing treatment accordingly helps. Some patient’s pathophysiology may dictate need aggressive airway clearance (AC), others combination of both AC and antibiotics while others needing bronchodilator, steroids etc. If anatomical issues are found to contributing, then those need to address like laryngeal cleft and H type tracheoesophageal fistulas. Preventative medicine equally plays role with immunization, prevention of smoking around children and pregnant women, hand hygiene, and parent education

Assessment and Earning CME Credit:

To receive CME credit for this course in Armenia, you must take the CME quiz at the end of this page. You have 3 chances to get a 70% to pass. Once you pass the quiz, we will send your information to the Armenia Ministry of Health for credits.

Dr. Manvi Bansal

Dr. Manvi Bansal

Dr. Manvi Bansal is a Clinical Associate Professor of Pediatrics at Children’s Hospital Los Angeles. Her interest in premature born children with bronchopulmonary dysplasia derives from her initial work during fellowship years. Children born prematurely often have comorbidities including significant lung disease, airway problems, and pulmonary hypertension, with limited information in literature leading to variable outpatient care. Dr. Bansal received the Dean’s fellowship award, funding two years of her fellowship for a project looking at desaturations in preterm infants as part of the NIH-funded multicenter study, Prematurity, and Respiratory Outcomes Program (PROP). She continued to work thereafter at CHLA as a Clinical Assistant and now as a Clinical Associate Professor, caring for and participating in research related to infants born premature. Dr. Bansal co-directs the infant chronic lung disease program at CHLA and serves as the Principal Investigator for her center for the multicenter initiative called BPD collaborative. Her research interests primarily lie in neonatal lung disease besides aerodigestive disorders, mechanical ventilation, flexible bronchoscopy, and childhood interstitial lung disease. She has mentored fellows in research related to BPD, with their work being presented at international American Thoracic Society conferences and eventually leading to publications in reputed journals. Additionally, she directs the flexible bronchoscopy and home mechanical ventilation program and regularly conducts didactics on the same for the fellowship program. Dr. Bansal enjoys collaboration and publications through her collaborations with her peers. In collaboration with ENT and GI colleagues, she co-directs the aerodigestive clinic and partners with other specialties like Anesthesia and Pediatric Surgery to strengthen both clinical and research frontiers.