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Bronchopulmonary dysplasia

BPD; Chronic lung disease - children; CLD - children

Bronchopulmonary dysplasia (BPD) is a long-term (chronic) lung condition that affects newborn babies who were either put on a breathing machine after birth or were born very early (prematurely).

Causes

BPD occurs in very ill infants who received high levels of oxygen for a long period. BPD can also occur in infants who were on a breathing machine (ventilator).

BPD is more common in infants born early (prematurely), whose lungs were not fully developed at birth.

Risk factors include:

Risk of severe BPD has decreased in recent years.

Symptoms

Symptoms may include any of the following:

Exams and Tests

Tests that may be done to help diagnose BPD include:

Treatment

IN THE HOSPITAL

Infants who have breathing problems are often put on a ventilator. This is a breathing machine that sends pressure to the baby's lungs to keep them inflated and to deliver more oxygen. As the baby's lungs develop, the pressure and oxygen are slowly reduced. The baby is weaned from the ventilator. The baby may continue to get oxygen by a mask or nasal tube for several weeks or months.

Infants with BPD are usually fed by tubes inserted into the stomach (NG tube). These babies need extra calories due to the effort of breathing. To keep their lungs from filling with fluid, their fluid intake may need to be limited. They may also be given medicines (diuretics) that remove water from the body. Other medicines can include corticosteroids, bronchodilators, and surfactant. Surfactant is a slippery, soapy-like substance in the lungs that helps the lungs fill with air and keeps the air sacs from deflating.

Parents of these infants need emotional support. This is because BPD takes time to get better and the infant may need to stay in the hospital for a long time.

AT HOME

Infants with BPD may need oxygen therapy for weeks to months after leaving the hospital. Follow your health care provider's instructions to ensure your baby gets enough nutrition during recovery. Your baby may need tube feedings or special formulas.

It is very important to prevent your baby from getting colds and other infections, such as respiratory syncytial virus (RSV). RSV can cause a severe lung infection, especially in a baby with BPD.

A simple way to help prevent RSV infection is to wash your hands often. Follow these measures:

Parents of babies with BPD should avoid crowds during outbreaks of RSV. Outbreaks are often reported by local news media.

Your baby's provider may prescribe the medicine palivizumab (Synagis) to prevent RSV infection in your baby. Follow instructions on how to give your baby this medicine.

Outlook (Prognosis)

Babies with BPD get better slowly over time. Oxygen therapy may be needed for many months. Some infants have long-term lung damage and require oxygen and breathing support, such as with a ventilator. Some infants with this condition may not survive.

Possible Complications

Babies who have had BPD are at greater risk for repeated respiratory infections, such as pneumonia, bronchiolitis, and RSV that require a hospital stay.

Other possible complications in babies who have had BPD are:

When to Contact a Medical Professional

If your baby had BPD, watch for any breathing problems. Call your child's provider if you see any signs of a respiratory infection.

Prevention

To help prevent BPD:

Related Information

Chronic
Respiratory
Neonatal respiratory distress syndrome
Community-acquired pneumonia in adults

References

Kamath-Rayne BD, Jobe AH. Fetal lung development and surfactant. In: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 16.

McGrath-Morrow SA, Collaco JM. Bronchopulmonary dysplasia. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 444.

Roosevelt GE. Pediatric respiratory emergencies: diseases of the lungs. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 169.

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Review Date: 5/30/2021  

Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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