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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.