Bronchopulmonary Dysplasia (BPD) is a chronic respiratory disease that is associated with premature and low-weight (2.2 ounces or 1,000 grams) infants born with underdeveloped lungs. It is identified by inflammation and scarring in the lungs. At times it may be called ‘chronic lung disease.’
Let’s break down the word:
Broncho refers to the bronchial tubes (airway). Oxygen travels through these tubes.
Pulmonary refers to the alveoli (tiny air sacs in the lungs). Oxygen and carbon dioxide is exchanged here.
Dysplasia means there are abnormal changes in a group of cells. The cell changes in BPD take place in the small airways and alveoli causing problems for lung function and making breathing difficult for the infant.
Most infants make a full recovery from BPD, but in some rare cases, combined with the other complications of prematurity, it could be fatal. According to the National Heart Lung and Blood Institute, there are between 5,000 and 10,000 cases per year. These tiny infants have been treated with supplemental oxygen or had a mechanical ventilator do the breathing for them for some time. The ventilator is essential to move the air through the trachea under pressure from the machine to push the oxygen into the stiff, underdeveloped lungs. Sometimes the pressure from the ventilator and the excess oxygen intake can injure a newborn’s delicate lungs, and may lead to Respiratory Distress Syndrome (RDS). If the symptoms continue and the baby is oxygen dependent and under 36 weeks gestational age the condition is called BPD. Babies are not born with BPD but genetics may play a part in some cases.
There are some other causes that an infant would be diagnosed with BPD such as trauma, pneumonia, and other infections. These all cause inflammation and scarring of the lungs associated with BPD. even in a full-term newborn or very rarely an older infants or children.
There is no treatment that can immediately cure bronchopulmonary displasia, rather there are treatments to support breathing and oxygen levels so that these infants will grow and thrive. They are first placed in the Neonatal Intensive Care Unit (NICU) until they are able to breathe well enough on their own without the assistance of a ventilator. These infants may be treated with certain medicines such as bronchodilators to keep the airways open and diuretics to reduce fluid build up in the lungs. Steroids may be used with a severe case of BPD. There are short term and long term side effects with these drugs so this would be a decision between you and the physician. Many times the baby is given a natural lubricant called surfactant to improve breathing function.
In some severe cases of BPD, the infant will not be able to use their gastrointestinal system to digest food and are given supplemental I.V.’s of TPN (Total Parenteral Nutrition) with all of the proteins, sugars and nutrients. The usual stay in the NICU for an infant with BPD is 120 days. Some babies will be discharged with medications, breathing treatments and oxygen at home. The child may be free of symptoms by the end of the first year or continue with some symptoms as long as the lungs are growing (5-7 years). Children that have been diagnosed with BPD will be more susceptible to infections such as the flu, RSV (respiratory sincytial virus) and pneumonia. Some may develop asthma, pulmonary edema or, rarely, pulmonary hypertension.