Bronchopulmonary Dysplasia
Bronchopulmonary dysplasia, or BPD, refers to the chronic respiratory
condition which frequently develops in significantly preterm infants who
have required ventilatory support. This condition typically presents with
chronic respiratory distress, changes in the respiratory tract itself
- such as increased airway resistance, pulmonary edema, pulmonary hypertension
- persistent supplemental oxygen dependence, and radiographic aberrancies.
BPD may develop following respiratory interventions in the premature neonatal
period which involve mechanical ventilation and oxygen administration.
In addition to the development of chronic lung disease, infants with
BPD may also be affected by problems with growth/nutrition, developmental
progression, and cardiovascular functioning. Gastroesophageal reflux is
common in preterm infants and presents a risk of chronic aspiration that
may aggravate the already existing lung injury of BPD. Bronchopulmonary
dysplasia additionally places the infant at risk for problems with neurodevelopment,
such as learning disabilities, cerebral palsy, seizure disorders, sensory
impairments, and problems with speech production.
Premature infants commonly require respiratory support because their
lungs aren't fully developed. This support typically consists of supplemental
oxygen therapy, continuous positive airway pressure (CPAP), and/or mechanical
ventilation. For infants whose lungs are not yet making surfactant, synthetic
surfactant must be administered exogenously, as mechanical ventilation
in the absence of adequate surfactant may induce atelectrauma (lung injury
from low pressure) from the continuing ventilation of lung tissue with
poor surface tension, or volutrauma, from the overextension and rupture
of normal lung tissue. Appropriate surfactant therapy typically improves
respiratory outcome and decreases incidence of BPD. Clinicians should
be aware of the various problems that may present in the infant who has
been diagnosed with BPD.
D'Angio, C.T., & Maniscalco, W.M. (2004). Bronchopulmonary
dysplasia in preterm infants: Pathophysiology and management strategies.
Pediatric Drugs, 6(5), 303-330.
Eisenberg, J.D. (2000). Chronic Respiratory Disorders.
In R.E. Nickel & L.W. Desch (Eds.), The physician's guide to caring
for children with disabilities and chronic conditions (pp. 622-624).
Baltimore, Maryland: Paul Brookes Publishing.