Can someone explain the whole CHF, BPD,edema thing?

  1. Can someone please explain to me exactly what causes CHF in neonates (some cause is anemia?), and then how that leads to BPD (what does the term bronchopulmonary dysplasia mean exactly anyway), and then how do diuretics help? (the answer to these questions could just be "because that's what happens!", but I am trying to connect it all in my head and it's hard to find the connections elsewhere)...thanks all! T.
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    About t2000JC

    Joined: Jan '02; Posts: 163; Likes: 8
    BSN RN


  3. by   shhh5683
    From what we just learned in class, this is my understanding of it...

    First there has to be lack of oxygen to part of one of the ventricles of the heart. Then, because that part is either inflamed or necrosed (dead), the ventricles cant squeeze all of the blood out of the chamber. Say for instance the baby has a blood clot. That will cause lack of oxygen which results in death of the tissue...lets just say this time, part of the left ventricle is necrosed. Then the left ventricle cant pump all of the blood out, so it backs up into the lungs, but at the same time, its not pumping out enough blood/oxygen, so other things are oxygen deprived too. So if the blood is backing up into the lungs, you have breathing problems. Because there is blood comming back from the left ventricle into the lungs and blood coming from the right ventricle to the lungs, there is excess fluid in the lungs, the veins' permeability is compromised and more fluid (water and sodium) leaks out of the veins which makes pleural effusion which just means that there is interstitial fluid around the alveoli. This also puts them at risk for dehydration. That inhibits normal breathing. When the fluid accumulates, it will move into the alveoli, further decreasing or eliminating oxygen exchange. That is pulmonary edema. Then you have unoxygenated blood circulating around in your system, and back to the heart too, so that there will be even more damage, not to mention decreased circulation in the extremities (because the body is trying to conserve its oxygen for the vital organs), hypercapnia (increased carbon dioxide) which makes acidosis. You also have to take into account the fact that you said they are neonates. If they are premies, they may not have enough surfactant (that usually develops around week 27) and that their lungs are not as strong as an adult.

    Sorry if this is not EXACTLY correct, but it made sense to me.
  4. by   t2000JC
    thanks guys, keep the thoughts coming! some babies develop chf in utero? how does that connect?
  5. by   kids
  6. by   kmaryniak
    Here's another good article:
  7. by   t2000JC
    Thanks Guys! The information was great and really connected it all together for me...Appreciate it! T.