What is bronchopulmonary dysplasia?

Bronchopulmonary dysplasia, or BPD, is a serious lung condition that affects newborns (mostly premature) and infants. This condition occurs when their lungs aren't fully formed and don't produce enough of a liquid substance that coats the inside of their lungs. This liquid, called surfactant, helps the lungs stay open and breathe. Without enough of this liquid, a baby has to work hard to breathe. They may not be able to get enough oxygen to their brain and other organs. Sometimes, babies that require life-saving treatment to breathe develop bronchopulmonary dysplasia.

Causes of bronchopulmonary dysplasia

Factors that contribute to bronchopulmonary dysplasia include:

  • Infants who weigh less than 2 pounds at birth
  • Infants diagnosed with respiratory distress syndrome, or RDS
  • Long-term use of a respirator and oxygen therapy
  • Infants who already have other breathing problems
  • Infants born more than 10 weeks before their due dates

Risk factors for bronchopulmonary dysplasia

The earlier the baby is born, the more likely it is they might develop bronchopulmonary dysplasia. Some infections and other conditions appear right before or just after birth. These include certain heart problems or bacterial infections. Babies who get bronchopulmonary dysplasia may start with respiratory distress syndrome, or RDS. If they still require treatment once they reach their actual due dates, they're diagnosed with bronchopulmonary dysplasia.

Other risk factors for bronchopulmonary dysplasia include:

  • Prolonged mechanical ventilation
  • High concentrations of inspired oxygen
  • Infection (eg, chorioamnionitis or sepsis)
  • Degree of prematurity
  • Male sex
  • Genetic susceptibility
  • Maternal smoking

Symptoms of bronchopulmonary dysplasia

Symptoms vary depending on the severity of bronchopulmonary dysplasia . All relate to an infant's difficulty breathing normally. Symptoms of bronchopulmonary dysplasia include:

  • Wheezing
  • Poor growth
  • Rapid or labored breaths
  • Repeated lung infections
  • A bluish color to the skin around the lips and nails, indicating low oxygen levels in the blood

Diagnosis of bronchopulmonary dysplasia

When babies need oxygen treatment, their lungs can swell and scar. The doctor may diagnose bronchopulmonary dysplasia if the baby still needs oxygen therapy at 36 weeks after conception, or 28 days after birth. Doctors may order chest X-rays. These are pictures that look at the baby's lungs. On the picture, their lungs may look spongy.

Treatments for bronchopulmonary dysplasia

The best thing for infants with bronchopulmonary dysplasia is to support their breathing and oxygen levels. This helps them grow and develop. Infants with bronchopulmonary dysplasia may go to the neonatal intensive care unit of the hospital. This is a special area for babies who need extra care. Doctors and nurses keep a close eye on them until they can breathe without a machine.

Larger hospitals may have a machine known as a jet ventilator. It uses continuous, low-pressure air. This can limit the amount of damage the breathing support might cause to small, developing lungs.

Doctors may prescribe medicines called bronchodilators. These keep airways open so the baby can breathe. Diuretics stop liquid from building up in the baby's lungs. Severe cases may need steroids and/or antibiotics. Babies may also receive natural or manmade surfactant. This is a treatment that helps the baby's lungs stay stable.

Babies with bronchopulmonary dysplasia may help eating. Nurses may give them high-calorie formula through a tube in their stomach. Nutrition through an IV may also be needed.

Recovery from bronchopulmonary dysplasia

Once a baby with bronchopulmonary dysplasia leaves the hospital, they may need oxygen therapy and medication. Treatments can last anywhere from a year or longer. There's a chance they might need it their entire life. Recovery is gradual. It's important to protect these babies from respiratory infections such as the flu or pneumonia. Try to follow the doctors' orders. Make sure your baby gets all the recommended vaccines. Keep your child away from tobacco smoke.

Your baby may start having trouble breathing. Call their doctor and seek medical care immediately. This is a serious condition. However, most babies make a full recovery and grow into healthy children. 

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