Bronchopulmonary Dysplasia (BPD)

Rapid, shallow breathingDifficulty breathingRetractionswith each breath, the chest appears to sink in between the ribs or under the ribcageCoughSee-saw breathingmovement of the chest and stomach in opposite directions with each breathWheezing or noisy breathingWet or cracking sound in the lungs, heard with a stethoscopeRaising or stretching the neck to push more air into the lungsPoor posture of the trunk, shoulders, and neckBluish color to the skinSlower than average growth rate Diagnosis Your doctor will review your childs medical history, and may perform the following tests: Arterial blood gas test a small amount of blood is drawn to determine how much oxygen is in it Chest x-ray radiation is used to take a picture of the inside of the chest; done to check for respiratory problems Chest CT scan a type of x-ray, which uses a computer to create images of structures inside the chest; performed to check for respiratory problems. Pulse-oximetry monitoringa piece of tape containing an oxygen sensor is placed on the babys foot; it is connected to a monitor that tells the doctor how well the lungs are working TreatmentThere is no specific treatment for BPD. Symptoms are treated to help the baby get strong and to allow the lungs to mature. Your child will most likely be treated in a hospitals neonatal intensive care unit. He or she may need to stay in the hospital for an extended period of time.

Talk with your doctor about the best treatment plan for your child. Treatment options include the following: Ventilator SupportA breathing machine is used until the baby can breathe well enough on his or her own. Supplemental OxygenOnce the baby no longer needs a ventilator, he or she may be given extra oxygen through a mask or a nasal tube. Treatment could continue for weeks or even months. Your baby might still need to receive oxygen after coming home from the hospital. MedicationAntibioticsto control infectionsBronchodilatorsto make it easier for air to get in and out of the lungsCorticosteroidsto reduce swelling and inflammation of the airwaysDiureticsto help remove extra fluid from the lungsSurfactantsto help the babys lungs expand the way they should Supplemental FeedingsAn intravenous (IV) line that delivers food may be attached to a vein. Or, a feeding tube may be inserted into the stomach. Special formula might also be given to the baby. This extra nutrition should help the baby get stronger and healthier. Physical TherapySpecial exercises help the babys muscles get stronger and help keep the lungs clear of mucus. Prevention There are no set guidelines for preventing BPD because the exact cause is not known. However there are some things you can do to help ensure you will give birth to a healthy baby:

Eat a healthful diet, one that is low in saturated fat and rich in low-fat dairy, lean protein sources, whole grains, fruits, and vegetables.Have regular prenatal check-ups.Dont smoke. If you smoke, quit.Avoid drugs and alcohol. RESOURCES: American Lung Associationhttp://www.lungusa.org Bronchopulmonary Dysplasia Home PageNational Heart, Lung, and Blood Institutehttp://www.nhlbi.nih.gov CANADIAN RESOURCES: The Canadian Lung Associationhttp://www.lung.ca The Hospital for Sick Childrenhttp://www.sickkids.ca References: Bancalari E, Claure N: Definitions and diagnostic criteria for bronchopulmonary dysplasia. Semin Perinatol 2006;30:164-70. Baveja R, Christou H: Pharmacological strategies in the prevention and management of bronchopulmonary dysplasia. Semin Perinatol . 2006;30:209-18. Bronchopulmonary dysplasia. American Lung Association website. Available at: http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=35017 . Accessed September 12, 2005. Bronchopulmonary dysplasia. National Heart, Lung, and Blood Institute website. Available at:http://www.nhlbi.nih.gov/health/dci/Diseases/Bpd/Bpd_All.html . Accessed September 12, 2005.

Bronchopulmonary dysplasia. US National Library of Medicine and the National Institutes of Health Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/001088.htm . Accessed September 12, 2005. Common questions about bronchopulmonary dysplasia. The University of Arizona Health Sciences Center website. Available at: www.peds.arizona.edu/neonatology/bpd.html. Accessed September 12, 2005. Glossary. The American Lung Association website. Available at: http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=40415&printmode=1#s . Accessed September 14, 2005. Respiratory distress syndrome in infants. US National Library of Medicine and the National Institutes of Health Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/001563.htm . Accessed September 14, 2005. Short EJ, Kirchner HL, Asaad GR et al: Developmental sequelae in preterm infants having a diagnosis of bronchopulmonary dysplasia: analysis using a severity-based classification system. Arch Ped adolesc Med . 2007;16:1082-7. Last reviewed January 2008 by David Juan, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.