Bronchopulmonary Dysplasia (BPD) / Chronic Lung Disease of Prematurity

What is Bronchopulmonary Dysplasia (BPD) / Chronic Lung Disease of Prematurity?

Bronchopulmonary dysplasia (BPD) is a breathing disorder where an infant’s lungs become irritated and do not develop normally. It occurs most often in low-weight infants born more than two months early.

Bronchopulmonary dysplasia is also known as:

  • Chronic lung disease of premature babies
  • Chronic lung disease of infancy
  • Neonatal chronic lung disease
  • Respiratory insufficiency

Bronchopulmonary dysplasia can be mild, moderate or severe. Many infants fully recover from this disorder. Others may have breathing difficulties during the first two years of life and even into the teen and adult years. Babies with this disorder are often in the hospital and need a lot of care.

Bronchopulmonary dysplasia is often seen in infants with respiratory distress syndrome (RDS). This breathing disorder is common in babies, born too early, since their lungs have not fully grown.

As many as 10,000 infants each year in the United States could develop this condition.


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What are the causes of bronchopulmonary dysplasia?

In most cases, this disorder develops after a premature baby receives additional oxygen or has been on a breathing machine (mechanical ventilator). When a baby is born too early, his lungs have not fully grown and oxygen is needed. This helps the baby breathe more easily. But giving oxygen under pressure — such as through a ventilator — can sometimes hurt the air sacs in the lungs. This can lead to bronchopulmonary dysplasia.

The disorder can also occur in infants who had an infection before or shortly after birth.

What are signs and symptoms of bronchopulmonary dysplasia?

Signs and symptoms of bronchopulmonary dysplasia include:

  • Breathing that is fast or difficult
  • Shortness of breath
  • Pauses in breathing that last for a few seconds (apnea)
  • Nostrils flare while breathing
  • Grunting while breathing
  • Wheezing
  • Skin pulling in between the ribs or collar bones (retractions)
  • Bluish color of the skin (cyanosis) – due to low oxygen levels in the blood

How is bronchopulmonary dysplasia diagnosed?

Most infants are diagnosed when they are already in the hospital. To diagnose this disorder, your child’s care team will consider:

  • Your baby’s symptoms
  • How premature your baby is
  • Your baby’s need for oxygen after a certain age

They may also use the following tests:

  • Chest X-rayCT scan or MRI – to see if the lungs are growing as they should
  • Blood test – to look at oxygen and carbon dioxide levels in the blood and look for infection
  • Echocardiogram (echo) – an ultrasound test to view the heart and find out if a heart problem is causing your baby’s breathing trouble
  • Pulse-oximetry- to continuously look at oxygen levels in the blood

How is bronchopulmonary dysplasia treated?

Your care team will use treatments to limit damage to your baby’s lungs. The goal with treatment is to allow your child’s lungs to heal and grow. Treatment for this chronic lung disease of prematurity can include:

  • Mechanical ventilator (breathing machine) – if long-term use is needed, your child may need a tracheostomy (a surgically placed breathing tube in the windpipe)
  • Oxygen
  • Nutrition therapy – to make sure your baby is getting enough nutrition to grow properly. Some babies will need a g-tube (gastrostomy tube) to allow nutrition to go through a tube directly into the stomach
  • Medications
    • Bronchodilators – to improve flow of air through the lungs
    • Diuretics – to reduce extra fluid o Antibiotics – to control infections and prevent pneumonia
    • Steroids – to decrease swelling in the lungs
    • Pulmonary Vasodilators - to improve blood flow to the lungs

Your child’s care team will adjust treatments over time as needed.

What is the long-term outlook for infants with bronchopulmonary dysplasia?

Babies with this disorder heal and grow at different rates. They usually get better over time. Some spend weeks, while others may need to stay for several months in the hospital’s Newborn Intensive Care Unit (NICU). Some fully recover, while others have lung problems as they grow into teens and adults.

Some babies go home without needing any more treatment. Others may need medicine, extra oxygen or a special diet at home.

Your child may need to see a lung and heart expert for check-ups after leaving the hospital.

Children who had bronchopulmonary dysplasia as infants may have a higher risk for certain types of breathing problems. This includes asthma, sleep apnea and respiratory infections.

Rarely, it can cause life-threatening problems such as pulmonary hypertension, a serious heart-lung condition.

Related Disorders / Conditions

Related disorders or conditions include:

What are the risk factors?

Those at greatest risk for developing bronchopulmonary dysplasia are infants who:

  • Are born more than 2 months early
  • Have a birth weight less than 2.2 pounds
  • Have respiratory distress syndrome

What are possible long-term complications?

Children who had bronchopulmonary dysplasia as infants may experience any of the following as they grow:

  • Health problems after leaving the hospital that involve oxygen therapy or breathing support
  • Higher risk for colds, flu and other infections
  • Trouble swallowing
  • Delayed growth and development, especially in the first two years after birth
  • Breathing problems as a child and adult

 

Last Updated 01/2019

 Who treats this.

The Bronchopulmonary Dysplasia (BPD) Center provides compassionate, high-quality care to premature infants and their families.

Judaea's Story

Judaea and family.
A mom’s tireless pursuit for answers leads to the Bronchopulmonary Dysplasia Center at Cincinnati Children’s. Read the Story