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By around the 37th week of pregnancy, babies will have developed to the point that they are able to survive outside the womb. Any child born before this point is referred to as premature. Thanks to the enormous progress in neonatology, which is a branch of pediatrics, even children who come into this world early now have a good chance at a healthy life. And yet the beginning is still a challenge for the very littlest patients: their survival often depends on how well developed their lungs are.


In prematurity, lung development and the onset of lung function is a crucial condition for survival. Depending on the degree of prematurity, the lungs may be partly developed or undeveloped, which makes it difficult to maintain adequate respiratory function in this group of newborns.



Support for Early Life Struggle and Chiesi

Chiesi has been working with neonatology community in the fight for survival of premature infants over 20 years with a total dedication to healthier, higher survival.


Nowadays, Chiesi provides survival to life struggle of premature babies in 80 countries in the framework of this collaboration and also transfers its works, its competencies to the field of most suitable clinical applications techniques.



Neonatal Respiratory Distress Syndrome

Neonatal Respiratory Distress Syndrome (RDS) is a typical situation for premature babies and it is a complicated clinical table in which more than one findings defined due to insufficient development of respiratory system. The severity and frequency of this condition depends on the degree of prematurity and in babies born before 20th week there is a higher risk of development.


Respiratory failure in infants with RDS is due to the fact that the biofilm-forming surfactant material in the lung surfactant pool is not at an adequate level by surrounding the inner wall of the lung air sacs. The physiological role of surfactant substance is to prevent collapse during exhalation by reducing the surface tension of the lungs and keeping the alveoli open. Absence or lack of surfactant substance in the lungs leads to respiratory distress, low oxygenation, increased breathing effort and respiratory support. Exogenous surfactant in RDS is important both for eliminating deficiencies and for substrate preparation for in vivo construction (Source: Hacettepe University Intensive Care Journal).


The amount of surfactant in the pulmonary pool of the premature baby is very low compared to the timely newborn. Therefore, the surfactant supplied to the external lungs when necessary, completes the amount of water in the pond and allows the air sacs to fill up with all of the biofilm layer.


Chiesi supports the premature infants in our country with the surfactant preparation used in this group of infants with respiratory failure.



Apnea (Respiratory Failure)


Apnea is a common problem in newborn intensive care units. Especially in the prematurity, many serious diseases may be detected as well as depending on the immune control of the respiratory system. Inadequate development of the respiratory system and respiratory center in the brain is a common problem for premature babies and the less the premature baby is developed or the less the birth weight of the baby is low, life-threatening events such as respiratory standstill (apnea) is more common. This situation usually develops as a sudden respiratory standstill that exceeds 20 seconds on days 2 and 3 of birth. Although many mild cases can be treated with respiratory support, medications containing caffeine are applied against respiratory arrest when necessary. In the treatment of apnea, caffeine has a stimulating effect on the central nervous system. Caffeine is preferred due to its long half-life, wide safety range and low side effect profile (Source: Selçuk University Medical Journal).


Chiesi presented caffeine citrate formulation for the treatment of Apnea in prematurity.


Future Developments


Generally speaking, there is a high and as yet unmet demand in neonatology for effective medications that are specifically approved for these tiny patients. Chiesi aims to help premature babies in their hard journeys and is working on multiple research projects to develop alternative treatments for premature babies, for example, to counteract brain injuries and bronchopulmonary dysplasia (one of the most common chronic lung disorders among premature babies) in future.