Bronchopulmonary dysplasia is a chronic lung disorder that may affect infants who have been exposed to high levels of oxygen therapy and ventilator support.
Causes, incidence, and risk factors
Bronchopulmonary dysplasia occurs in severely ill infants who have received high concentrations of oxygen for long periods of time and prolonged support on respiratory ventilators during treatment for the infant respiratory distress syndrome of the newborn. The lung injury that produces bronchopulmonary dysplasia may be caused by a combination of factors: increased pressure in the lungs from mechanical ventilators or from the oxygen toxicity that occurs when the lung is exposed to very high concentrations of oxygen for prolonged periods. Risk factors include prematurity, respiratory infection, congenital heart disease , or other severe illness in the newborn period requiring therapy with oxygen and/or ventilators.
Treatment
Additional ventilator support is usually required to deliver pressure to the lungs to keep lung tissue inflated, and to deliver supplemental oxygen. Pressures and oxygen concentrations are slowly reduced as the infant tolerates. When the infant is weaned from the ventilator, oxygen may continue by a mask or nasal cannula for several weeks to months. Infants are usually fed by tubes inserted into the stomach. Extra calories are needed due to the increased need for calories with the effort of breathing. Fluids may be restricted, and the infant may be given diuretics to keep the lungs from filling with fluid. Parents of these infants require emotional support as the resolution of the disease is often very slow, and hospitalization may be prolonged.
Expectations (prognosis)
Improvement is generally gradual. Some infants may require oxygen therapy for many months. Some infants may not survive with this condition.
Complications
Babies who have experienced BPD are at a greater risk for developing recurrent respiratory infections requiring hospitalization (see pneumonia ). Many of the cystic changes of the airways (bronchioles) that occur in babies with bronchopulmonary dysplasia are permanent.
Calling your health care provider
If your baby had BPD, watch for any breathing problems ; call your health care provider if any signs of a respiratory infection are present.
Prevention
Early weaning from respiratory support, if possible, may help to decrease the incidence of this condition.