Bronchopulmonary Dysplasia
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Bronchopulmonary Dysplasia

(BPD)

Pronounced: Brong-ko-PUL-mo-ner-ee Dis-PLAY-se-ah

En Español (Spanish Version)

Definition

Bronchopulmonary dysplasia (BPD) is a chronic lung disease that mainly affects infants born prematurely. Babies with BPD have trouble breathing because their lungs do not work properly. The condition usually develops during the first four weeks after birth.

Most babies who get BPD recover, but this is a serious condition that requires care from your doctor.

Bronchopulmonary Dysplasia

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Causes

Several factors contribute to BPD, including:

  • Immature lungs
  • Baby receives a high concentrations of oxygen for long periods of time
  • Baby is put on a ventilator—a breathing machine—for an extended time period
  • Infections
  • Pneumonia

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition. The following factors increase your child’s chances of developing BPD:

  • Collapsed lung
  • Premature birth
  • High blood pressure
  • Congenital heart disease (eg, patent ductus arteriosus)
  • Tracheomalacia
  • Subglottic stenosis
  • Respiratory distress syndrome (RDS)—a lung disorder often affecting premature babies that causes difficulty with breathing
  • Any severe illness requiring oxygen therapy and/or the use of a ventilator

Symptoms

If your infant experiences any of these symptoms do not assume it is due to BPD. These symptoms may be caused by other, less serious health conditions.

  • Rapid, shallow breathing
  • Difficulty breathing
  • Retractions—with each breath, the chest appears to sink in between the ribs or under the ribcage
  • Cough
  • See-saw breathing–movement of the chest and stomach in opposite directions with each breath
  • Wheezing or noisy breathing
  • Wet or cracking sound in the lungs, heard with a stethoscope
  • Raising or stretching the neck to push more air into the lungs
  • Poor posture of the trunk, shoulders, and neck
  • Bluish color to the skin
  • Slower than average growth rate

Diagnosis

Your doctor will review your child’s medical history, and may perform the following tests:

  • Arterial blood gas test—a small amount of blood is drawn to determine how much oxygen is in it
  • Chest x-ray—radiation is used to take a picture of the inside of the chest; done to check for respiratory problems
  • Chest CT scan—a type of x-ray, which uses a computer to create images of structures inside the chest; performed to check for respiratory problems.
  • Pulse-oximetry monitoring—a piece of tape containing an oxygen sensor is placed on the baby’s foot; it is connected to a monitor that tells the doctor how well the lungs are working

Treatment

There is no specific treatment for BPD. Symptoms are treated to help the baby get strong and to allow the lungs to mature. Your child will most likely be treated in a hospital’s neonatal intensive care unit. He or she may need to stay in the hospital for an extended period of time.

Talk with your doctor about the best treatment plan for your child. Treatment options include the following:

Ventilator Support

A breathing machine is used until the baby can breathe well enough on his or her own.

Supplemental Oxygen

Once the baby no longer needs a ventilator, he or she may be given extra oxygen through a mask or a nasal tube. Treatment could continue for weeks or even months. Your baby might still need to receive oxygen after coming home from the hospital.

Medication

  • Antibiotics—to control infections
  • Bronchodilators—to make it easier for air to get in and out of the lungs
  • Corticosteroids—to reduce swelling and inflammation of the airways
  • Diuretics—to help remove extra fluid from the lungs
  • Surfactants—to help the baby’s lungs expand the way they should

Supplemental Feedings

An intravenous (IV) line that delivers food may be attached to a vein. Or, a feeding tube may be inserted into the stomach. Special formula might also be given to the baby. This extra nutrition should help the baby get stronger and healthier.

Physical Therapy

Special “exercises” help the baby’s muscles get stronger and help keep the lungs clear of mucus.

Prevention

There are no set guidelines for preventing BPD because the exact cause is not known. However there are some things you can do to help ensure you will give birth to a healthy baby:

  • Eat a healthful diet, one that is low in saturated fat and rich in low-fat dairy, lean protein sources, whole grains, fruits, and vegetables.
  • Have regular prenatal check-ups.
  • Don’t smoke. If you smoke, quit.
  • Avoid drugs and alcohol.

RESOURCES:

American Lung Association
http://www.lungusa.org

Bronchopulmonary Dysplasia Home Page
National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES:

The Canadian Lung Association
http://www.lung.ca

The Hospital for Sick Children
http://www.sickkids.ca

References:

Bancalari E, Claure N: Definitions and diagnostic criteria for bronchopulmonary dysplasia. Semin Perinatol 2006;30:164-70.

Baveja R, Christou H: Pharmacological strategies in the prevention and management of bronchopulmonary dysplasia. Semin Perinatol . 2006;30:209-18.

Bronchopulmonary dysplasia. American Lung Association website. Available at: http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=35017 . Accessed September 12, 2005.

Bronchopulmonary dysplasia. National Heart, Lung, and Blood Institute website. Available at:
http://www.nhlbi.nih.gov/health/dci/Diseases/Bpd/Bpd_All.html . Accessed September 12, 2005.

Bronchopulmonary dysplasia. US National Library of Medicine and the National Institutes of Health Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/001088.htm . Accessed September 12, 2005.

Common questions about bronchopulmonary dysplasia. The University of Arizona Health Sciences Center website. Available at: www.peds.arizona.edu/neonatology/bpd.html. Accessed September 12, 2005.

Glossary. The American Lung Association website. Available at: http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=40415&printmode=1#s . Accessed September 14, 2005.

Respiratory distress syndrome in infants. US National Library of Medicine and the National Institutes of Health Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/001563.htm . Accessed September 14, 2005.

Short EJ, Kirchner HL, Asaad GR et al: Developmental sequelae in preterm infants having a diagnosis of bronchopulmonary dysplasia: analysis using a severity-based classification system. Arch Ped adolesc Med . 2007;16:1082-7.



Last reviewed January 2008 by David Juan, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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