Bronchopulmonary dysplasia
Definition
Bronchopulmonary dysplasia (BPD) is a chronic lung condition that affects newborn babies who are put on a breathing machine at birth.
Alternative Names
BPDCauses
Bronchopulmonary dysplasia (BPD) occurs in severely ill infants who have received high levels of oxygen for long periods of time or who have been on a ventilator during treatment for respiratory distress syndrome. It is more common in infants born early (premature) whose lungs were not fully developed at birth.
Risk factors include:
- Prematurity
- Respiratory infection
- Congenital heart disease
- Other severe illness in the newborn that needs to be treated with oxygen or a ventilator
The risk of severe BPD has decreased in recent years.
Symptoms
- Rapid breathing
- Bluish skin color
- Shortness of breath
Exams and Tests
- Chest x-ray
- Arterial blood gas
- Chest CT scan
- Pulse oximetry
Treatment
Extra ventilator support is usually needed to send pressure to the lungs to keep the baby's lung tissue inflated, and to deliver more oxygen. Pressures and oxygen levels are slowly reduced. After being weaned from the ventilator, the infant may continue to get oxygen by a mask or nasal tube for several weeks or months.
Infants with BPD are usually fed by tubes inserted into the stomach (NG tube). These babies need extra calories due to the effort of breathing. Infants may need to limit fluids, and may be given medications that remove water from the body (diuretics) to keep the lungs from filling with fluid. Other medications can include corticosteroids, bronchodilators, and surfactants.
Parents of these infants need emotional support, because it can take time for the disease to get better, and the infant may need to stay in the hospital for a long period of time.
Outlook (Prognosis)
Babies with bronchopulmonary dysplasia get better slowly over time. It's possible for infants to need oxygen therapy for many months. Some infants with this condition might not survive.
Possible Complications
Babies who have had BPD are at a greater risk for having recurrent respiratory infections (such as pneumonia) that require a hospital stay. Many of the airway (bronchiole) changes in babies with bronchopulmonary dysplasia will not go away.
When to Contact a Medical Professional
If your baby had BPD, watch for any breathing problems. Call your health care provider if you see any signs of a respiratory infection.
Prevention
Taking the baby off the breathing assistance early, if possible, and using a substance that helps open the baby's lungs (surfactant) can help prevent this condition.
References
Murray J, Nadel J. Textbook of Respiratory Medicine. 3rd ed. Philadelphia, Pa: WB Saunders; 2000.
Smith VC. Trends in severe bronchopulmonary dysplasia rates between 1994 and 2002. J Pediatr. 2005; 146(4): 469-73.
Cogo PE. Surfactant kinetics in preterm infants on mechanical ventilation who did and did not develop bronchopulmonary dysplasia. Crit Care Med. 2003; 31(5): 1532-8.
Reviewed By: Allen J. Blaivas, DO, Pulmonary, Critical Care, and Sleep Medicine, Department of Veteran Affairs, VA System, East Orange, NJ. Review provided by VeriMed Healthcare Network.
