Common complications of dysregulated inflammation in the neonate

Preterm infants are faced with a multitude of challenges related to immature systems at delivery placing them at risk for both acute and chronic health conditions. A major component of the human immune system is the inflammatory process and the primary controllers of inflammation are cytokines. Cytokine expression is tightly regulated in the normal host immune response, but in neonates, particularly those born prematurely, the dysregulation is more the norm than the exception. A state in which the inflammatory systems are persistently activated can lead to chronic inflammation affecting the neonate systemically rather than targeting a specific location of illness, injury, or both. Serious neonatal morbidities including white matter injury, chronic lung disease, retinopathy of prematurity and necrotizing enterocolitis have been linked to this chronic inflammatory state. Through the use of a systems approach this article will serve as a focused review of these common neonatal complications. First, an overview explaining the human immune system and the complex process of inflammation will be presented with a focus on systemic neonatal response following acute and/or chronic inflammation. This review is important to promote an understanding of one of the multifactorial influences, inflammation, contributing to long term neonatal health challenges. Empirically supported nursing implications and recommended care strategies are highlighted.