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Bronchopulmonary dysplasia Causes and Risks:
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 as treatment for respiratory distress syndrome usually associated with prematurity . Injury to lung tissue is caused from a combination of factors: increased pressure in the lungs from ventilators, oxygen toxicity, and from tube placement in the trachea to deliver oxygen (called endotracheal intubation ). Risk factors include
prematurity, respiratory infection, congenital heart disease , or other severe illness in the newborn period requiring therapy with oxygen and/or ventilators.
Prevention:
Early weaning from respiratory support, if possible, may help to decrease the incidence of this condition.
Symptoms:
Signs and Tests:
chest x-ray
arterial blood gas
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.
Prognosis:
Some infants may not survive with this condition. Improvement is generally gradual. Some infants may require oxygen therapy for many months.
Complications:
Babies who have experienced BPD are at a greater risk for developing recurrent respiratory infections requiring hospitalization (see pneumonia ).
Call Your Healthcare 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.
This is an illustration of the major features of the lungs and bronchial tree. The inset is of the alveoli. They are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.
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