Understanding the Sequence of Pulmonary Injury in the Extremely Low Birth Weight, Surfactant-Deficient Infant

Human lung development begins around day 26 postconception and continues throughout early childhood. Many crucial events can affect this delicate tissue as it develops, leading to altered and abnormal growth and development of the lungs, thereby yielding a variety of morbidities and sometimes even mortality. Understanding the pathophysiology of lung injury in the extremely low birth weight neonate is essential when caring for these infants, especially during the first hours of life. This article provides bedside clinicians with foundational information related to acute lung injury and the sequence of events that can ultimately lead to neonatal chronic lung disease and bronchopulmonary dysplasia.