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Bronchopulmonary Dysplasia (Risk factor (Other risk factors (Patent ductus…
Bronchopulmonary Dysplasia
Pathology
is associated with inflammation and scarring in the lungs
the condition results from damage to the lungs caused by mechanical ventilation (respirator) and long-term use of oxygen.
the amount of oxygen an infant requires at time of birth and the length of use of supplemental oxygen or mechanical ventilation.
Definite
Prematurely born infants, especially those born before 28 weeks of gestation, have very few tiny air sacs (alveoli) at birth
The alveoli that are present tend to not be mature enough to function normal, and the infant requires respiratory support with oxygen or mechanical ventilation (a respirator) to support breathing
Although life-saving, these treatments can also cause lung damage, referred to as "broncho [airway] pulmonary [lung] dysplasia," or BPD.
Risk factor
Prolonged mechanical ventilation: Mechanical ventilation stretches the alveoli. When overstretched, and for longer periods of time, that may damage them.
Degree of prematurity: The less developed the lungs, the more they are likely to be damanged and result in BPD. BPD is rare in infants born after 32 weeks of pregnancy.
High concentrations of oxygen: The higher the concentration of oxygen and longer duration it is given, the higher the possibility of developing BPD. In general, concentrations of less than 60% oxygen are considered to be relatively safe.
Male gender: Male infants are more likely to be born prematurely and to develop BPD.
Maternal conditions: Maternal smoking or use of illicit drugs, maternal malnutrition, and infections in the mother during the pregnancy may affect the normal growth of the fetus, and may lead to premature labor, development of respiratory distress syndrome, and eventually to BPD.
Other risk factors
Patent ductus arterosus. The ductus arteriosus is a blood vessel
connects the right and left side of the heart that closes shortly after birth.
This vessel is more likely to remain open in premature infants
causing lung damage when too much blood flows into the lungs.
Intrauterine growth retardation (IUGR): Different conditions may affect the growth of the fetus during the pregnancy and may also lead to premature labor. Relatively undeveloped lungs are more likely to develop BPD.
Symptoms
Labored breathing (drawing in of the lower chest while breathing in)
Wheezing (a soft whistling sound as the baby breathes out)
Rapid breathing
Bluish discoloration of the skin around the lips and nails due to low oxygen in the blood
Poor growth
Repeated lung infections that may require hospitalization
Diagnosis
The diagnosis of BPD is based on the infant's clinical situation, how premature he or she is, and the need for oxygen after a certain age. There are no blood tests, and biopsies are not needed.
Treatment
Corticosteroids: These drugs reduce and/or prevent the inflammation within the lungs. They help reduce swelling within the walls of the windpipes and decrease the amount of mucus that is produced. Like bronchodilators, they are also usually given as an aerosol with a mask, either with use of a nebulizer or an inhaler with a spacer.
Viral immunization: Children with BPD are at increased risk from respiratory tract infections especially respiratory syncytial virus (RSV). Infants with moderate or severe BPD receive monthly injections with a medication that helps prevent the infection during the RSV season.
Diuretics: This class of drugs helps to decrease the amount of fluid in and around the alveoli. They are usually given by mouth 1 to 4 times per day.
Cardiac medications: A few infants with BPD may require special medications that help relax the muscles around the blood vessels in the lung, allowing the blood to pass more freely reduce the strain on the heart.