Bronchopulmonary dysplasia: Difference between revisions

From WikiMD's Wellness Encyclopedia

m 1 revision imported
 
CSV import
 
(6 intermediate revisions by the same user not shown)
Line 1: Line 1:
{{SI}}
{{Infobox medical condition
| name          = Bronchopulmonary dysplasia
| image          = [[File:CXR_-_Bronchopulmonary_dysplasia.jpg|250px]]
| caption        = Chest X-ray of a patient with bronchopulmonary dysplasia
| synonyms      = Chronic lung disease of prematurity
| field          = [[Pediatrics]], [[Neonatology]]
| symptoms      = [[Tachypnea]], [[retractions]], [[hypoxemia]], [[cyanosis]]
| complications  = [[Pulmonary hypertension]], [[growth failure]], [[neurodevelopmental impairment]]
| onset          = Usually in [[premature infants]]
| duration      = Can be chronic
| causes        = [[Premature birth]], [[mechanical ventilation]], [[oxygen toxicity]]
| risks          = [[Prematurity]], [[low birth weight]], [[prolonged mechanical ventilation]]
| diagnosis      = [[Chest X-ray]], [[clinical evaluation]]
| differential  = [[Respiratory distress syndrome]], [[pneumonia]], [[congenital heart disease]]
| prevention    = [[Antenatal steroids]], [[surfactant therapy]], [[gentle ventilation strategies]]
| treatment      = [[Oxygen therapy]], [[diuretics]], [[bronchodilators]], [[nutritional support]]
| prognosis      = Variable; some improve with age, others may have long-term complications
| frequency      = Affects a significant number of very low birth weight infants
}}
{{Short description|A chronic lung disease affecting premature infants}}
{{Infobox medical condition (new)
{{Infobox medical condition (new)
| name           = Bronchopulmonary dysplasia
| name         = Bronchopulmonary dysplasia
| synonyms       =  
| synonyms     = BPD
| image           = CXR - Bronchopulmonary dysplasia.jpg
| image         = CXR - Bronchopulmonary dysplasia.jpg
| caption         = a radiograph of bronchopulmonary dysplasia
| caption       = Chest X-ray of bronchopulmonary dysplasia showing diffuse haziness and areas of hyperinflation
| pronounce       =  
| pronounce     =  
| field           =  
| field         = [[Pulmonology]], [[Neonatology]]
| symptoms       =  
| symptoms     = [[Tachypnea]], [[retractions]], hypoxemia, need for prolonged [[oxygen therapy]]
| complications   =  
| complications = [[Pulmonary hypertension]], [[growth failure]], recurrent [[respiratory infections]]
| onset           =  
| onset         = Typically within the first 4 weeks of life
| duration       =  
| duration     = Chronic; may persist into childhood
| types           =  
| types         = Mild, moderate, severe (based on oxygen requirement at 36 weeks postmenstrual age)
| causes         =  
| causes       = Lung injury from mechanical ventilation and/or oxygen therapy
| risks           =  
| risks         = Prematurity, low birth weight, infection, PDA, high oxygen exposure
| diagnosis       =  
| diagnosis     = Clinical criteria, oxygen requirement at 28 days and 36 weeks PMA, [[chest X-ray]]
| differential   =  
| differential = [[Respiratory distress syndrome]], [[congenital pneumonia]], pulmonary hypoplasia
| prevention     =  
| prevention   = [[Antenatal corticosteroids]], [[non-invasive ventilation]], [[surfactant therapy]]
| treatment       =  
| treatment     = Respiratory support, nutrition, bronchodilators, diuretics, corticosteroids
| medication     =  
| medication   = [[Albuterol]], [[furosemide]], [[dexamethasone]]
| prognosis       =  
| prognosis     = Variable; some resolve over time, others have long-term respiratory issues
| frequency       =  
| frequency     = ~10,000–15,000 cases/year in the U.S.
| deaths         =  
| deaths       = Associated with severity; improved survival with neonatal care advances
}}
}}
'''Bronchopulmonary dysplasia''' ('''BPD'''; formerly '''chronic lung disease of infancy''') is a chronic [[lung]] disease in which premature infants, usually those who were treated with supplemental oxygen, require long-term oxygen.<ref>[http://www.merckmanuals.com/professional/pediatrics/perinatal-problems/bronchopulmonary-dysplasia-bpd Merck Manual, Professional Edition], Bronchopulmonary Dysplasia (BPD).</ref>The alveoli that are present tend to not be mature enough to function normal.<ref>{{Cite web|url=https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/bronchopulmonary-dysplasia/|title=Bronchopulmonary Dysplasia|website=American Lung Association|language=en|access-date=2020-03-12}}</ref> It is more common in infants with [[low birth weight]] (LBW) and those who receive prolonged [[mechanical ventilation]] to treat [[Infant respiratory distress syndrome|respiratory distress syndrome]] (RDS). It results in significant morbidity and mortality.  The definition of BPD has continued to evolve primarily due to changes in the population, such as more survivors at earlier gestational ages, and improved neonatal management including surfactant, antenatal glucocorticoid therapy, and less aggressive mechanical ventilation.<ref name="pmid5334613">{{cite journal|last=Northway Jr|first=WH|author2=Rosan, RC |author3=Porter, DY |title=Pulmonary disease following respirator therapy of hyaline-membrane disease. Bronchopulmonary dysplasia.|journal=The New England Journal of Medicine|date=Feb 16, 1967|volume=276|issue=7|pages=357–68|doi=10.1056/NEJM196702162760701|pmid=5334613}}</ref>
'''Bronchopulmonary dysplasia''' ('''BPD''') is a chronic [[lung disease]] that primarily affects [[premature birth|premature infants]] who have received [[mechanical ventilation]] or supplemental [[oxygen therapy]] to treat [[respiratory distress syndrome]] (RDS). It is characterized by abnormal development of the [[alveoli]], inflammation, and pulmonary fibrosis, leading to long-term respiratory difficulties.
 
== History ==
Currently the description of BPD includes the grading of its severity into mild, moderate and severe. This correlates with the infant's maturity, growth and overall severity of illness.<ref name="pmid15538399">{{cite journal|last=Sahni|first=R|author2=Ammari, A |author3=Suri, MS |author4=Milisavljevic, V |author5=Ohira-Kist, K |author6=Wung, JT |author7= Polin, RA |title=Is the new definition of bronchopulmonary dysplasia more useful?|journal=Journal of Perinatology|date=Jan 2005|volume=25|issue=1|pages=41–6|pmid=15538399|doi=10.1038/sj.jp.7211210|doi-access=free}}</ref> The new system offers a better description of underlying pulmonary disease and its severity.<ref name="pmid16322158">{{cite journal|last=Ehrenkranz|first=RA|author2=Walsh, MC |author3=Vohr, BR |author4=Jobe, AH |author5=Wright, LL |author6=Fanaroff, AA |author7=Wrage, LA |author8=Poole, K |author9= National Institutes of Child Health and Human Development Neonatal Research, Network  |title=Validation of the National Institutes of Health consensus definition of bronchopulmonary dysplasia|journal=Pediatrics|date=Dec 2005|volume=116|issue=6|pages=1353–60|pmid=16322158|doi=10.1542/peds.2005-0249}}</ref>
The term "bronchopulmonary dysplasia" was first described in 1967 by Dr. William Northway to characterize the chronic lung damage observed in premature infants treated with high levels of oxygen and prolonged mechanical ventilation. Advances in [[neonatal intensive care]] have since altered the presentation and understanding of BPD, shifting from scarring to more developmental arrest in alveolarization.
 
== Pathophysiology ==
==Presentation==
BPD results from a combination of factors that injure the immature lungs, including:
=== Complications ===
* Barotrauma from [[mechanical ventilation]]
Feeding problems are common in infants with BPD, often due to prolonged intubation. Such infants often display [[oral-tactile hypersensitivity]] (also known as oral aversion).<ref>Gaining & Growing. [http://depts.washington.edu/growing/Assess/BPD.htm "Bronchopulmonary dysplasia"], ''Gaining & Growing'', March 20, 2007. (Retrieved June 12, 2008.)</ref>
* Oxygen toxicity from high inspired oxygen concentrations
Physical findings:
* Inflammatory responses to infection or ventilation
* [[hypoxemia]];
* Poor postnatal nutrition
* [[hypercapnia]];
These injuries disrupt the normal development of alveoli and pulmonary vasculature. The lungs of infants with BPD show fewer, larger alveoli with thickened septa, impaired gas exchange, and increased airway resistance.
* [[crackles]], [[wheezing]], & decreased breath sounds;
== Risk Factors ==
* increased bronchial secretions;
Risk factors for developing BPD include:
* [[hyperaeration|hyperinflation]];
* Extreme [[prematurity]] (especially <28 weeks gestation)
* frequent [[lower respiratory infections]];
* Very low [[birth weight]] (<1500g)
* delayed growth & development;
* Prolonged requirement for [[positive pressure ventilation]]
* [[cor pulmonale]];
* High concentrations of inspired oxygen
* [[Chest X-ray|CXR]] shows with hyperinflation, low diaphragm, [[atelectasis]], cystic changes.
* Prenatal or postnatal [[infections]] (e.g., [[chorioamnionitis]], [[sepsis]])
 
* [[Patent ductus arteriosus]] (PDA)
== Cause  ==
* Genetic susceptibility and intrauterine growth restriction (IUGR)
Prolonged high oxygen delivery in premature infants causes [[necrotizing bronchiolitis]] and alveolar septal injury, with inflammation and scarring. This results in [[hypoxemia]]. Today, with the advent of [[surfactant therapy]] and [[High Frequency Ventilation|high frequency ventilation]] and oxygen supplementation, infants with BPD experience much milder injury without necrotizing bronchiolitis or alveolar septal fibrosis. Instead, there are usually uniformly dilated [[acini]] with thin alveolar septa and little or no interstitial fibrosis. It develops most commonly in the first 4 weeks after birth.
== Clinical Presentation ==
 
Signs and symptoms may include:
* Persistent [[tachypnea]] and [[retractions]]
* Difficulty weaning from respiratory support
* Poor feeding and [[failure to thrive]]
* Need for supplemental oxygen beyond 28 days of life
* Recurrent [[respiratory infections]]
* Signs of [[pulmonary hypertension]] in severe cases
== Diagnosis ==
== Diagnosis ==
 
BPD is diagnosed based on:
===Earlier criteria===
* The need for oxygen supplementation at 28 days of life and at 36 weeks postmenstrual age (PMA)
The classic diagnosis of BPD may be assigned at 28 days of life if the following criteria are met:
* Severity classification (mild, moderate, severe) depends on oxygen dependency and respiratory support at 36 weeks PMA or 56 days of life
#Positive pressure ventilation during the first 2 weeks of life for a minimum of 3 days.
* [[Chest X-ray]] may show areas of:
#Clinical signs of abnormal respiratory function.
** [[Atelectasis]]
#Requirements for supplemental oxygen for longer than 28 days of age to maintain PaO2 above 50&nbsp;mm Hg.
** Hyperinflation
#Chest radiograph with diffuse abnormal findings characteristic of BPD.
** Linear opacities or cystic changes
 
* Pulmonary function testing and echocardiography may aid in assessment
===Newer criteria===
== Management ==
 
Management of BPD involves a multidisciplinary approach:
The newer National Institute of Health (US) criteria for BPD (for neonates treated with more than 21% oxygen for at least 28 days)<ref name="pmid16650652">{{cite journal|last=Kinsella|first=JP|author2=Greenough, A |author3=Abman, SH |title=Bronchopulmonary dysplasia|journal=Lancet|date=Apr 29, 2006|volume=367|issue=9520|pages=1421–31|pmid=16650652|doi=10.1016/S0140-6736(06)68615-7}}</ref> is as follows:,<ref>{{cite web|title = Bronchopulmonary Dysplasia|url = http://patient.info/doctor/bronchopulmonary-dysplasia |work = Patient.info |accessdate=2 February 2014}}</ref><ref>{{cite journal |last1=Jobe |first1=AH |last2=Bancalari |first2=E |title=Bronchopulmonary dysplasia |journal=Am J Respir Crit Care Med |date=June 2001 |volume=163|issue=7 |pages=1723–9 |doi=10.1164/ajrccm.163.7.2011060 |pmid=11401896}}</ref>
* Respiratory support: Minimize further lung injury using non-invasive methods like CPAP or nasal cannula when possible
 
* Pharmacologic therapy:
;Mild
** [[Bronchodilators]] (e.g., albuterol)
* Breathing room air at 36 weeks' post-menstrual age or discharge (whichever comes first) for babies born before 32 weeks, or
** [[Diuretics]] (e.g., furosemide) to reduce pulmonary edema
* breathing room air by 56 days' postnatal age, or discharge (whichever comes first) for babies born after 32 weeks' gestation.
** [[Corticosteroids]] (e.g., dexamethasone or hydrocortisone) in select cases
 
* Nutrition: High-calorie feeds and possible [[gastrostomy]] to support growth and healing
;Moderate
* Treatment of complications: Monitor for and manage [[pulmonary hypertension]], tracheomalacia, and infections
* Need for <30% oxygen at 36 weeks' postmenstrual age, or discharge (whichever comes first) for babies born before 32 weeks, or
== Complications ==
* need for <30% oxygen to 56 days' postnatal age, or discharge (whichever comes first) for babies born after 32 weeks' gestation.
Long-term complications of BPD may include:
 
* Chronic obstructive lung disease in childhood
;Severe
* [[Asthma]]-like symptoms
* Need for >30% oxygen, with or without positive pressure ventilation or continuous positive pressure at 36 weeks' postmenstrual age, or discharge (whichever comes first) for babies born before 32 weeks, or
* Recurrent [[bronchiolitis]] or pneumonia
* need for >30% oxygen with or without positive pressure ventilation or continuous positive pressure at 56 days' postnatal age, or discharge (whichever comes first) for babies born after 32 weeks' gestation.
* Need for home oxygen or [[tracheostomy]] in severe cases
 
* [[Neurodevelopmental delay]] due to prolonged NICU stay
==Management==
== Prognosis ==
There is evidence to show that steroids given to babies less than 8 days old can prevent bronchopulmonary dysplasia.<ref name=":0">{{Cite journal|last=Doyle|first=Lex W|last2=Cheong|first2=Jeanie L|last3=Ehrenkranz|first3=Richard A|last4=Halliday|first4=Henry L|date=2017-10-24|title=Early (< 8 days) systemic postnatal corticosteroids for prevention of bronchopulmonary dysplasia in preterm infants|journal=Cochrane Database of Systematic Reviews|volume=10|pages=CD001146|doi=10.1002/14651858.cd001146.pub5|issn=1465-1858|pmid=29063585|pmc=6485683}}</ref> However, the risks of neurodevelopmental sequelae may outweigh the benefits.<ref name=":0" /> It is unclear if starting steroids more than 7 days after birth is harmful or beneficial.<ref name=":1">{{Cite journal|last=Doyle|first=Lex W|last2=Cheong|first2=Jeanie L|last3=Ehrenkranz|first3=Richard A|last4=Halliday|first4=Henry L|date=2017-10-24|title=Late (> 7 days) systemic postnatal corticosteroids for prevention of bronchopulmonary dysplasia in preterm infants|journal=Cochrane Database of Systematic Reviews|volume=10|pages=CD001145|doi=10.1002/14651858.cd001145.pub4|issn=1465-1858|pmid=29063594|pmc=6485440}}</ref> It is thus recommended that they only be used in those who cannot be taken off of a ventilator.<ref name=":1" /> Evidence suggests that vitamin A in LBW babies is associated with a reduction in mortality and bronchopulmonary dysplasia.<ref>{{Cite journal|last=Guimarães|first=Hercília|last2=Guedes|first2=Maria Beatriz|last3=Rocha|first3=Gustavo|last4=Tomé|first4=Teresa|last5=Albino-Teixeira|first5=António|date=2012|title=Vitamin A in prevention of bronchopulmonary dysplasia|journal=Current Pharmaceutical Design|volume=18|issue=21|pages=3101–3113|issn=1873-4286|pmid=22564302|doi=10.2174/1381612811209023101}}</ref>
Prognosis depends on:
 
* Degree of prematurity
[[Oxygen therapy]] at home is recommended in those with significant low oxygen levels.<ref>{{cite journal |last1=Hayes D |first1=Jr |last2=Wilson |first2=KC |last3=Krivchenia |first3=K |last4=Hawkins |first4=SMM |last5=Balfour-Lynn |first5=IM |last6=Gozal |first6=D |last7=Panitch |first7=HB |last8=Splaingard |first8=ML |last9=Rhein |first9=LM |last10=Kurland |first10=G |last11=Abman |first11=SH |last12=Hoffman |first12=TM |last13=Carroll |first13=CL |last14=Cataletto |first14=ME |last15=Tumin |first15=D |last16=Oren |first16=E |last17=Martin |first17=RJ |last18=Baker |first18=J |last19=Porta |first19=GR |last20=Kaley |first20=D |last21=Gettys |first21=A |last22=Deterding |first22=RR |title=Home Oxygen Therapy for Children. An Official American Thoracic Society Clinical Practice Guideline. |journal=American Journal of Respiratory and Critical Care Medicine |date=1 February 2019 |volume=199 |issue=3 |pages=e5–e23 |doi=10.1164/rccm.201812-2276ST |pmid=30707039|pmc=6802853 }}</ref>
* Severity of lung damage
 
* Presence of comorbidities
==Epidemiology==
With modern neonatal care, survival rates have improved, and many infants recover lung function over time. However, some children continue to have respiratory and developmental issues into adolescence.
The rate of BPD varies among institutions, which may reflect neonatal risk factors, care practices (e.g., target levels for acceptable oxygen saturation), and differences in the clinical definitions of BPD.<ref name="pmid17306659">{{cite journal|vauthors=Fanaroff AA, Stoll BJ, Wright LL, Carlo WA, Ehrenkranz RA, Stark AR | title=Trends in neonatal morbidity and mortality for very low birthweight infants | journal=Am J Obstet Gynecol | year= 2007 | volume= 196 | issue= 2 | pages= 147.e1–8 | pmid=17306659 | doi=10.1016/j.ajog.2006.09.014 | pmc= |display-authors=etal}}</ref><ref name="pmid10835057">{{cite journal|vauthors=Van Marter LJ, Allred EN, Pagano M, Sanocka U, Parad R, Moore M | title=Do clinical markers of barotrauma and oxygen toxicity explain interhospital variation in rates of chronic lung disease? The Neonatology Committee for the Developmental Network | journal=Pediatrics | year= 2000 | volume= 105 | issue= 6 | pages= 1194–201 | pmid=10835057 | doi= 10.1542/peds.105.6.1194| pmc= | url= |display-authors=etal}}</ref><ref name="pmid14726936">{{cite journal|vauthors=Ellsbury DL, Acarregui MJ, McGuinness GA, Eastman DL, Klein JM | title=Controversy surrounding the use of home oxygen for premature infants with bronchopulmonary dysplasia | journal=J Perinatol | year= 2004 | volume= 24 | issue= 1 | pages= 36–40 | pmid=14726936 | doi=10.1038/sj.jp.7211012 | pmc= | doi-access=free }}</ref>
== Prevention ==
 
Preventive measures include:
* [[Antenatal corticosteroids]] to accelerate fetal lung maturation
* Early use of [[surfactant]] therapy
* Minimizing invasive ventilation using [[CPAP]] or [[NIPPV]]
* Targeted oxygen saturation goals to reduce oxygen toxicity
* Infection control and nutritional support
== See also ==
== See also ==
* [[Infant respiratory distress syndrome|Respiratory distress syndrome]]
* [[Premature birth]]
* [[Wilson–Mikity syndrome]]
* [[Respiratory distress syndrome]]
 
* [[Pulmonary fibrosis]]
== References ==
* [[Patent ductus arteriosus]]
{{Reflist}}
* [[Pediatric pulmonology]]
 
* [[Neonatal intensive care unit]]
== Further reading ==
* {{cite journal|last=Bhandari|first=A|author2=Bhandari, V|title=Bronchopulmonary dysplasia: an update|journal=Indian Journal of Pediatrics|date=Jan 2007|volume=74|issue=1|pages=73–7|pmid=17264460|doi=10.1007/s12098-007-0032-z|url=https://www.researchgate.net/publication/6541014}}
* [http://www.nhlbi.nih.gov/health/health-topics/topics/bpd/ Bronchopulmonary Dysplasia] on National Institutes of Health
== External links ==
== External links ==
{{Medical resources
* [https://www.nhlbi.nih.gov/health-topics/bronchopulmonary-dysplasia NHLBI – Bronchopulmonary Dysplasia]
| DiseasesDB      = 1713
* [https://www.nichd.nih.gov/health/topics/bpd NICHD – Bronchopulmonary Dysplasia Overview]
| ICD10          = {{ICD10|P|27|1|p|20}}
{{Certain conditions originating in the perinatal period}}  
| ICD9            = {{ICD9|770.7}}
{{Respiratory diseases}}  
| ICDO            =
{{Neonatology}}  
| OMIM            =
{{Stub}}
| MedlinePlus    = 001088
| eMedicineSubj  = ped
| eMedicineTopic  = 289
| MeshID          = D001997
| Orphanet        = 70589
}}
{{Certain conditions originating in the perinatal period}}
 
[[Category:Bronchus disorders]]
[[Category:Bronchus disorders]]
[[Category:Neonatology]]
[[Category:Neonatology]]
[[Category:Rare diseases]]
[[Category:Respiratory diseases]]
[[Category:Pediatrics]]
[[Category:Lung disorders]]
[[Category:Conditions diagnosed in infancy]]

Latest revision as of 19:37, 4 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics

Bronchopulmonary dysplasia
Synonyms Chronic lung disease of prematurity
Pronounce N/A
Specialty N/A
Symptoms Tachypnea, retractions, hypoxemia, cyanosis
Complications Pulmonary hypertension, growth failure, neurodevelopmental impairment
Onset Usually in premature infants
Duration Can be chronic
Types N/A
Causes Premature birth, mechanical ventilation, oxygen toxicity
Risks Prematurity, low birth weight, prolonged mechanical ventilation
Diagnosis Chest X-ray, clinical evaluation
Differential diagnosis Respiratory distress syndrome, pneumonia, congenital heart disease
Prevention Antenatal steroids, surfactant therapy, gentle ventilation strategies
Treatment Oxygen therapy, diuretics, bronchodilators, nutritional support
Medication N/A
Prognosis Variable; some improve with age, others may have long-term complications
Frequency Affects a significant number of very low birth weight infants
Deaths N/A


A chronic lung disease affecting premature infants


Bronchopulmonary dysplasia
Synonyms BPD
Pronounce
Field Pulmonology, Neonatology
Symptoms Tachypnea, retractions, hypoxemia, need for prolonged oxygen therapy
Complications Pulmonary hypertension, growth failure, recurrent respiratory infections
Onset Typically within the first 4 weeks of life
Duration Chronic; may persist into childhood
Types Mild, moderate, severe (based on oxygen requirement at 36 weeks postmenstrual age)
Causes Lung injury from mechanical ventilation and/or oxygen therapy
Risks Prematurity, low birth weight, infection, PDA, high oxygen exposure
Diagnosis Clinical criteria, oxygen requirement at 28 days and 36 weeks PMA, chest X-ray
Differential diagnosis Respiratory distress syndrome, congenital pneumonia, pulmonary hypoplasia
Prevention Antenatal corticosteroids, non-invasive ventilation, surfactant therapy
Treatment Respiratory support, nutrition, bronchodilators, diuretics, corticosteroids
Medication Albuterol, furosemide, dexamethasone
Prognosis Variable; some resolve over time, others have long-term respiratory issues
Frequency ~10,000–15,000 cases/year in the U.S.
Deaths Associated with severity; improved survival with neonatal care advances


Bronchopulmonary dysplasia (BPD) is a chronic lung disease that primarily affects premature infants who have received mechanical ventilation or supplemental oxygen therapy to treat respiratory distress syndrome (RDS). It is characterized by abnormal development of the alveoli, inflammation, and pulmonary fibrosis, leading to long-term respiratory difficulties.

History[edit]

The term "bronchopulmonary dysplasia" was first described in 1967 by Dr. William Northway to characterize the chronic lung damage observed in premature infants treated with high levels of oxygen and prolonged mechanical ventilation. Advances in neonatal intensive care have since altered the presentation and understanding of BPD, shifting from scarring to more developmental arrest in alveolarization.

Pathophysiology[edit]

BPD results from a combination of factors that injure the immature lungs, including:

  • Barotrauma from mechanical ventilation
  • Oxygen toxicity from high inspired oxygen concentrations
  • Inflammatory responses to infection or ventilation
  • Poor postnatal nutrition

These injuries disrupt the normal development of alveoli and pulmonary vasculature. The lungs of infants with BPD show fewer, larger alveoli with thickened septa, impaired gas exchange, and increased airway resistance.

Risk Factors[edit]

Risk factors for developing BPD include:

Clinical Presentation[edit]

Signs and symptoms may include:

Diagnosis[edit]

BPD is diagnosed based on:

  • The need for oxygen supplementation at 28 days of life and at 36 weeks postmenstrual age (PMA)
  • Severity classification (mild, moderate, severe) depends on oxygen dependency and respiratory support at 36 weeks PMA or 56 days of life
  • Chest X-ray may show areas of:
    • Atelectasis
    • Hyperinflation
    • Linear opacities or cystic changes
  • Pulmonary function testing and echocardiography may aid in assessment

Management[edit]

Management of BPD involves a multidisciplinary approach:

  • Respiratory support: Minimize further lung injury using non-invasive methods like CPAP or nasal cannula when possible
  • Pharmacologic therapy:
  • Nutrition: High-calorie feeds and possible gastrostomy to support growth and healing
  • Treatment of complications: Monitor for and manage pulmonary hypertension, tracheomalacia, and infections

Complications[edit]

Long-term complications of BPD may include:

Prognosis[edit]

Prognosis depends on:

  • Degree of prematurity
  • Severity of lung damage
  • Presence of comorbidities

With modern neonatal care, survival rates have improved, and many infants recover lung function over time. However, some children continue to have respiratory and developmental issues into adolescence.

Prevention[edit]

Preventive measures include:

  • Antenatal corticosteroids to accelerate fetal lung maturation
  • Early use of surfactant therapy
  • Minimizing invasive ventilation using CPAP or NIPPV
  • Targeted oxygen saturation goals to reduce oxygen toxicity
  • Infection control and nutritional support

See also[edit]

External links[edit]

Conditions originating in the perinatal period / fetal disease
Maternal factors
complicating pregnancy,
labour or delivery
Growth
Birth trauma
Affected systems
Infections




Respiratory diseases
Upper respiratory tract
Lower respiratory tract
Pleural cavity
Pulmonary vascular diseases
Related conditions and diseases
This respiratory disease-related article is a stub.




Neonatology
Foundations
Conditions
Procedures and Therapies
Professionals and Organizations
Related Topics
This Neonatology related article is a stub.


This article is a medical stub. You can help WikiMD by expanding it!
PubMed
Wikipedia
Retrieved from "https://wikimd.com/index.php?title=Bronchopulmonary_dysplasia&oldid=6544568"