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Bronchopulmonary Dysplagia (BPD) (Clinical Signs & Symptoms (Tachypnea…
Bronchopulmonary Dysplagia (BPD)
Etiology
Most common form of chronic lung disease in children
Host susceptibility and genetic disposition
Oxygen toxicity
Inflammation
Neonatal infection
Mechanical ventilation
Pulmonary edema and patent ductus arteriosus
Pathophysiology
Hyaline membrane formation
Atelectasis
Excessive bronchial secretions
Chronic alveolar fibrosis and bronchial smooth muscle hypertrophy
Bronchial mucosal metplasia and hyperplasia
Alveolar hyperinflation
Emphysematous areas surrounded by areas of atelectasis and normal alveoli
Diagnostic Testing
CXR
Stage I
Ground-glass granular pattern
Small lung volumes
Stage II
Patchy opaque areas
Bronchograms (atelectasis)
Hyperinflation
Stage III
Circular or cysticlike areas of hyper lucency surrounded by patches of irregular density areas caused by atlectasis
"Spongelike" appearance :red_flag:
Stage IV
Increase in the size and number of cyst like areas
Emphysematous bulae and interstitial fibrosis
"Honeycomb" appearance :red_flag:
Differential Diagnosis
CXR
"Spongelike" appearance or "honeycomb" appearance :red_flag:
Respiratory Management
Oxygen therapy
Bronchopulmonary hygiene therapy
Mechanical ventilation
Permissive hypercapnia to avoid lung injury
Mother is given steroids to hasten the lung maturity
Surfactant
Clinical Signs & Symptoms
Tachypnea
Tachycardia
Hypertension
Intercostal retractions
Substernal retractions and abdominal distention
Flaring nostrils
Cyansosis
BS: Wheezes Crackles
Expiratory grunting
AKA: Chronic lung disease of prematurity of infancy
Mild: Infant can maintain satisfactory oxygenation breathing room air
Moderate: Infant needs supplemental O2, but no more than 30% to maintain satisfactory oxygenation
Severe: Infant needs more than 30% O2 to maintain satisfactory oxygenation