Bronchopulmonary dysplasia

A chronic lung disease affecting newborns

Bronchopulmonary dysplasia (BPD) is a chronic lung disease that primarily affects premature infants who have received oxygen therapy or mechanical ventilation. It is characterized by inflammation and scarring in the lungs.

Pathophysiology

BPD develops as a result of injury to the lungs caused by mechanical ventilation and oxygen therapy, which are often necessary for the survival of premature infants. The condition is marked by inflammation, fibrosis, and impaired alveolar development. The alveoli, which are the tiny air sacs in the lungs where gas exchange occurs, are underdeveloped and fewer in number in infants with BPD.

Risk Factors

Several factors increase the risk of developing BPD, including:

• Premature birth, particularly before 28 weeks of gestation
• Low birth weight
• Prolonged mechanical ventilation
• High concentrations of oxygen therapy
• Infections, such as sepsis or pneumonia
• Patent ductus arteriosus (PDA)

Clinical Presentation

Infants with BPD often present with:

• Respiratory distress
• Need for prolonged respiratory support
• Difficulty weaning from oxygen therapy
• Recurrent respiratory infections

Diagnosis

The diagnosis of BPD is typically made based on the clinical history of the infant, including the need for oxygen therapy beyond 28 days of life, and characteristic findings on chest X-rays, which may show areas of atelectasis, hyperinflation, and cystic changes.

Management

Management of BPD involves a multidisciplinary approach, including:

• Optimizing respiratory support to minimize lung injury
• Nutritional support to promote growth and lung development
• Medications such as bronchodilators, diuretics, and corticosteroids
• Monitoring and treating complications such as pulmonary hypertension

Prognosis

The prognosis for infants with BPD varies. Some infants may experience significant improvement as they grow, while others may have long-term respiratory problems. Early intervention and careful management can improve outcomes.

Prevention

Preventive strategies for BPD include:

• Use of antenatal corticosteroids to accelerate lung maturity in preterm infants
• Minimizing the use of mechanical ventilation and oxygen therapy
• Use of non-invasive ventilation techniques
• Administration of surfactant therapy

Related pages

• Premature birth
• Respiratory distress syndrome
• Neonatology