Bronchopulmonary dysplasia (bpd) is a chronic respiratory disease that most often occurs in low-weight or premature infants who have received supplemental oxygen or have spent long periods of time on a breathing machine (mechanical ventilation), such as infants who have acute respiratory distress syndrome.
2. Bronchopulmonary Dysplasia (BPD)
Bronchopulmonary Dysplasia (BPD) is a chronic
respiratory disease that most often occurs in low-
weight or premature infants who have received
supplemental oxygen or have spent long periods of time
on a breathing machine (mechanical ventilation), such
as infants who have acute respiratory distress
syndrome. The disease can also occur in older infants
who experience abnormal lung development or some
infants that have had an infection before birth
(antenatal infection) or placental abnormalities.
3. Causes of Bronchopulmonary dysplasia
Bronchopulmonary dysplasia is caused by damage to the
delicate tissue of the lungs. This damage is most often
occurs in infants who have required extended treatment
with supplemental oxygen or breathing assistance with a
machine (mechanical ventilation) such as infants who are
born prematurely and have acute respiratory distress
syndrome.
When infants receive mechanical ventilation, a tube is
inserted through the windpipe and the machine pushes air
into the lungs, which are often underdeveloped in
premature infants. In some cases, the levels of oxygen
required for an affected infant to survive are higher than
normally would be found in the air we breathe. Over time,
the constant pressure from the ventilator and the excess
oxygen levels can damage the delicate tissues of an infant’s
lungs causing inflammation and scarring.
4. Causes of Bronchopulmonary dysplasia
The exact, underlying mechanisms that cause
classic or new Bronchopulmonary dysplasia are
complex and not fully understood. The causes of
Bronchopulmonary dysplasia in one infant may be
different from the causes in another. Most likely,
multiple different environmental and genetic
factors all play a role in the development of the
disorder.
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5. Symptoms
Some infants who develop bronchopulmonary
dysplasia have a condition called respiratory distress
syndrome (RSD), which is a breathing disorder that
affects some premature infants immediately after birth. It
is characterized by rapid, shallow breathing and leads to
the need for oxygen and respiratory support in the first
days of life. Affected infants may also exhibit shortness of
breath, a chronic cough, flaring of the nostrils when
breathing, and bluish discoloration of the skin due to low
levels of oxygen in the blood.
In most cases, infants with bronchopulmonary dysplasia
recover fully and damage to the lungs progressively
improves with growth. In a few rare cases, BPD can cause
life-threatening complications during infancy such as high
blood pressure of the main artery of the lungs (pulmonary
hypertension) and failure of the right side of the heart.
6. Treatments
The treatment for infants with Bronchopulmonary dysplasia is
geared toward minimizing damage to the lungs and providing
enough support to allow an affected infant’s lungs heal and
grow. The specific therapies used may change as an affected
infant grows and the clinical picture changes.
Newborns with bronchopulmonary dysplasia usually receive
care in the hospital. Treatment may include mechanical
ventilation. Ventilators are only used when absolutely necessary
and affected infants are taken off as early as possible. Some
infants may require supplemental oxygen after being taking off
mechanical ventilation. Proper nutritional management is also
necessary to ensure the proper growth and development of the
lungs. Some affected infants may require the insertion of a
gastrointestinal (GI) tube directly into the stomach to ensure the
sufficient intake of calories and nutrients. Because infants with
BPD are at risk for the accumulation of excess fluid in the lungs,
daily fluid intake may be monitored and adjusted.
7. Treatments
Infants with BPD remain at a greater risk of
developing respiratory infections and pneumonia
than the general population. They should avoid
individuals who have upper respiratory infections.
In some cases, affected infants may receive
preventive therapy with palivizumab, an antibody
that protects against respiratory syncytial virus
(RSV) infection. RSV is a common and contagious
winter infection that can potentially cause
pneumonia.
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