Bronchopulmonary Dysplasia | Treatment Approach

How We Treat Bronchopulmonary Dysplasia

In the Bronchopulmonary Dysplasia (BPD) Center at Cincinnati Children’s, we take a team approach. That means a variety of providers who are specialists in their fields will see your child based on what his or her individual needs are. We provide multidisciplinary care and discuss each patient in depth and develop a personalized treatment plan together.

A team approach also means that we make it a priority to educate you on your child’s condition, so you have the knowledge you need to partner with us in your child’s care.

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Inpatient Care

When your baby is cared for by our team, you will be in close contact with our BPD Center liaison, an advanced practice nurse, who will be your main contact with our multidisciplinary care team. Our entire team works to understand the subtle changes in each patient regarding their lung, airway and heart function, and make recommendations regarding therapies, ventilator management and potential surgical interventions. As your main contact, your liaison will ensure you are always up to date regarding your child’s care plan and will assist with answering any of your questions.

Treatment Options

Treatment of BPD is unique for each child. We evaluate the level of lung, airway and heart involvement, and then personalize a treatment plan that focuses on your child’s type of BPD. Your child’s treatment may include one or more of the following:

  • Oxygen Therapy: Babies with BPD often can’t take in enough oxygen on their own since their lungs are underdeveloped and injured.
  • Mechanical Ventilator: To support your baby’s breathing when they may not be strong enough to breathe on their own.
  • Medications: To reduce inflammation, increase blood flow to the lungs, help keep your baby’s airways open, or to reduce fluid buildup in the lungs.
  • Tracheostomy: To help support your baby’s airway and provide stable breathing support.
  • Nutritional Support: To supplement your baby’s unique nutritional and growth needs, additional feedings may be needed through a feeding tube.

Advanced Diagnostics

The following tests and procedures are often used for diagnosing and treating children with BPD.

  • MRI: To help us determine the factors that contribute to your baby’s type of BPD and help us determine the best treatment plan for your baby. We are the first center in the world to use this breakthrough imaging technology.
  • Blood Tests: To show how much oxygen is in the blood and look for signs of infection.
  • Chest X-Rays: To assess the health of the lungs.
  • Echocardiograms (Echo): To see a moving picture of the heart. We combine echo with MRI, which allows for the most comprehensive diagnostic of pulmonary hypertension in infants.
  • Modern Ventilation Strategies: Using the most current equipment and newest approaches that have been advanced by our world-leading experts for tailoring the ventilator settings for individual patients.
  • Bronchoscopy: To understand the structure and movement of the airway during normal breathing.
  • Impulse Oscillometry: To measure how well the upper and lower airways are working.
  • Lung Clearance Index: To assess how uniform ventilation is.

Long-term Outlook

Babies with BPD stay in the NICU for a wide range of time. Some may stay in the NICU for just a few weeks, and others will stay for months. We aim to help educate parents and families about their child’s illness, so you can learn what to expect about your baby’s length of stay in the NICU, as well as what it takes to care for a baby with a respiratory illness.

Babies with bronchopulmonary dysplasia improve gradually over time. Some recover lung function that is close to normal, while others have long-term lung damage requiring significant medical care over their lifetime.

Some babies go home with a home ventilator. We have care managers who will help you learn about your child’s respiratory care, including home ventilators, so you feel comfortable caring for them after they are discharged.

Outpatient Care

Here’s what to expect when your child returns for care to our BPD Center after being discharged:

Infants typically have an initial evaluation and treatment tailored by the BPD team when they are in the NICU. The goal of care at this time is to have the baby graduate from the NICU to home, to our Transitional Care Center, or back to the referring hospital.

After your child is discharged, he or she will be seen for follow-up appointments in our BPD Clinic, with Neonatology and Pulmonary Medicine doctors who are part of the BPD team and who have followed your child from their arrival at Cincinnati Children’s. Monitoring lung function is crucial in the early years, so your child will be seen often during the first year of life. Until your child is age 3, you can expect to visit us:

  • Every three months in the first year of life
  • Every six months after the first birthday
  • Then annually or as needed

Appointments with Cardiology and other disciplines are scheduled as needed.

Children ages 3 and up are followed in the BPD Clinic in Pulmonary Medicine so we can keep a close eye on the health of the airway and lungs, as well as related conditions, as your child grows. By continuing to see your child at regular follow-up visits, we are able to monitor patients who may experience symptoms similar to asthma as they grow older.

These appointments are normally scheduled once a year or more frequently as needed.

We typically perform pulmonary function testing at age 5 for children with BPD. These are a group of tests that measure how well the lungs are working. They will show the doctors how well your child is able to breathe and how effective the lungs are in bringing oxygen to the rest of the body.

If you’re ever concerned about your child’s lung function in between regular clinic visits, you can always call for additional appointments as needed.

Parent Resources

  • Patient Stories
    • Learn about the stories of patients treated by the Bronchopulmonary Dysplasia Center.
  • Transporting a Child to Cincinnati Children’s
    • The Pediatric Transport Team offers a state-of-the-art mobile intensive care unit environment that allows for the transport of critically ill newborns from local, regional, national and international referral sites. In-house teams are available 24 hours a day, seven days a week to allow a rapid response for medical transports.
  • Visiting Cincinnati Children’s
    • Let Concierge Services (formerly Guest Services) help you plan your travel details so you can concentrate on your child. We can help out before you travel and after you and your family arrive. We do whatever it takes to make sure a family’s time with us is as stress-free and comfortable as possible.
    • Concierge Services has professional, knowledgeable staff to take care of the many complex details of arranging a visit to Cincinnati Children’s for out-of-town families. A Concierge Services associate can assist your family with discounted lodging rates at many local hotels. Read more about where to stay.