BPD

1. Broncho
pulmonary
dysplasia(BPD)
NAME:-CHAUDHARY CHETAN
GROUP:-IM-645

2. Bronchopulmonary dysplasia
Bronchopulmonary dysplasia (BPD) is a form of chronic lung disease that affects newborns,
most often those who are born prematurely and need oxygen therapy.
In BPD the lungs and the airways (bronchi) are damaged, causing tissue destruction
(dysplasia) in the tiny air sacs of the lung (alveoli).

3. Risk factors
•Pulmonary interstitial emphysema
•High peak inspiratory pressures
•Large end-tidal volumes
•Repeated alveolar collapse
•Increased airway resistance

4. Diagnosis
Diagnosis
•National Institute of Child Health and Human Development (NICHD) criteria
•Characteristic x-ray findings

5. National Institute of Child Health and
Human Development (NICHD) criteria
These criteria are in addition to the baseline diagnostic requirement of needing> 21% oxygen for at least 28 days
or continued need for supplemental oxygen at ≥ 36 weeks PMA.
† Assessed at 36 weeks PMA.
‡ Assessed at age 29 to 55 days

6. National Institute of Child Health and Human
Development Criteria for Diagnosis of
Bronchopulmonary Dysplasia
< 32 Weeks Gestational Age† ≥ 32 Weeks Gestational Age‡ Diagnosis
Breathing room air at 36 weeks PMA or
or discharge, whichever comes first
Breathing room air by 56 days
postnatal age or discharge, whichever
comes first
Mild BPD
Need for < 30% oxygen at 36 weeks
PMA or discharge, whichever comes
first
Need for < 30% oxygen at 56 days
postnatal age or discharge, whichever
comes first
Moderate BPD
Need for ≥ 30% oxygen, positive
pressure, or both at 35 weeks PMA or
discharge, whichever comes first
Need for ≥ 30% oxygen, positive
pressure, or both at 56 days postnatal
age or discharge, whichever comes
first
Severe BPD

7. BPD (X-Ray and CT findings)

8. Treatment
Treatment
•Nutrition supplementation
•Fluid restriction
•Diuretics
•Oxygen supplementation as needed
•Respiratory syncytial virus (RSV) monoclonal antibody (palivizumab)

9. Treatment
Daily fluid intake is often restricted to about 120 to 140 mL/kg/day.
Oral chlorothiazide 10 to 20 mg/kg 2 times a day
◦ OR
Furosemide (1 to 2 mg/kg IV or IM or 1 to 4 mg/kg orally every 12 to 24
hours for neonates and every 8 hours for older infants)
◦ Arterial oxygenation should be continuously monitored with a pulse oximeter and
maintained at ≥ 89% saturation.
◦ Respiratory acidosis may occur during ventilator weaning and treatment and is acceptable
as long as the pH remains > 7.25 and the infant does not develop severe respiratory
distress.