Bronchopulmonary Dysplasia
En Español (Spanish Version)

Definition
Bronchopulmonary dysplasia (BPD) is abnormal development of the lungs in infants. It is considered a chronic lung disease. BPD can make it difficult for the infant to breathe. The condition usually develops in the first four weeks after birth.

Infant Airway and Lungs

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Causes
The exact cause of BPD is unknown. It is most often associated with complication of early lung disease or their treatments. These conditions or treatments can cause irritation and swelling of lungs and airways. This can lead to BPD.

Risk Factors
Factors that increase your infant’s risk of developing BPD include:

  • Any severe illness requiring oxygen therapy and/or the use of a ventilator for an extended time
  • Respiratory distress syndrome (RDS)—a lung disorder often affecting premature babies that causes difficulty with breathing
  • Collapsed lung
  • Premature birth
  • Immature lungs
  • High blood pressure
  • Congenital heart diseases that cause excess blood flow through the lungs such as patent ductus arteriosus
  • Tracheomalacia
  • Subglottic stenosis
  • Infections
  • Pneumonia
Symptoms
Symptoms may include:

  • 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
  • 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
Diagnosis
Your infant’s medical history will be taken. A physical exam will be done.

Your infant’s bodily fluids may be tested. This can be done with blood tests.

Your infant’s lung function may be tested. This can be done with pulse oximetry monitoring.

Images may be taken of your infants bodily structures. This can be done with:

Treatment
There is no specific treatment for BPD. The main focus is to treat any symptoms. If needed, treatment may include support for your infant's breathing. This will help the infant get strong and allow the lungs to mature.

Your infant will most likely be treated in a hospital. An extended hospital stay may be needed. Talk with your doctor about the best treatment plan for your infant. Treatment options include the following:

Ventilator Support
A breathing machine is used to move air in and out of lungs. It can support your infant's breathing until he or she is stronger and can breathe well enough without help.

Supplemental Oxygen
Oxygen may be delivered through a mask or nasal tube. It may be done by itself or after the ventilator is no longer needed. This treatment could continue for weeks or even months. Your infant may still need oxygen after coming home from the hospital.

Medication
Medication will be chosen based on your infant's needs. Medications may include:

  • Surfactants—may be given soon after birth to help the infant’s lungs expand the way they should
  • 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
    • Note: Certain corticosteroids are not recommended in pre-term infants. Talk to your doctor about which medication is right for your child.
  • Diuretics—to help remove extra fluid from the lungs
Supplemental Feedings
Lung problems can make feeding difficult. Nutrition therapy can help the infant get stronger and healthier. It may include:

  • An IV line that connects directly to a vein
  • A feeding tube that is inserted into the stomach
  • Special formula for bottlefeeding
Early Intervention Therapy
Early intervention therapy may include several types of therapy. They will help improve your infant's development. It may include special exercises to improve muscle strength and clear mucus from the lungs.

Prevention
There are no set guidelines for preventing BPD. However, there are some things you can do to decrease the risk of a premature birth and ensure you will give birth to a healthy infant such as:

  • Eat a healthful diet. Choose foods low in saturated fat and rich in low-fat dairy. Choose lean protein sources. Include plenty of whole grains, fruits, and vegetables in your diet.
  • Have early and regular prenatal check-ups.
  • Don’t smoke. If you smoke, quit.
  • Avoid drugs and alcohol.



RESOURCES:
American Lung Association

Healthy Children—American Academy of Pediatrics

CANADIAN RESOURCES:
The Canadian Lung Association


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.lung.org/lung-disease/bronchopulmonary-dysplasia. Accessed September 8, 2014.

Bronchopulmonary dysplasia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 12, 2014. Accessed September 8, 2014.

Respiratory distress syndrome (RDS) of the newborn . EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 7, 2014. Accessed September 8, 2014.

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.

4/1/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Choosing wisely. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 26, 2014. Accessed April 1, 2014.

Last Reviewed August 2014



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