Bronchopulmonary dysplasia
| Bronchopulmonary dysplasia | |
|---|---|
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| a radiograph of bronchopulmonary dysplasia | |
| Classification and external resources | |
| Specialty | pediatrics |
| ICD-10 | P27.1 |
| ICD-9-CM | 770.7 |
| DiseasesDB | 1713 |
| MedlinePlus | 001088 |
| eMedicine | ped/289 |
| Patient UK | Bronchopulmonary dysplasia |
| MeSH | D001997 |
Bronchopulmonary dysplasia (BPD; formerly chronic lung disease of infancy) is a chronic lung disorder of infants and children first described in 1967. It is more common in infants with low birth weight and those who receive prolonged mechanical ventilation to treat respiratory distress syndrome (RDS). It results in significant morbidity and mortality. The definition of BPD has continued to evolve since then primarily due to changes in the population, such as more survivors at earlier gestational ages, and improved neonatal management including surfactant, antenatal glucocorticoid therapy, and less aggressive mechanical ventilation.
Currently the description of BPD includes the grading of its severity into mild, moderate and severe. This correlates with the infant's maturity, growth and overall severity of illness. The new system offers a better description of underlying pulmonary disease and its severity.
The classic diagnosis of BPD may be assigned at 28 days of life if the following criteria are met:
The newer National Institute of Health (US) criteria for BPD (for neonates treated with more than 21% oxygen for at least 28 days) is as follows:,
Prolonged high oxygen delivery in premature infants causes necrotizing bronchiolitis and alveolar septal injury, with inflammation and scarring. This results in hypoxemia. Today, with the advent of surfactant therapy and high frequency ventilation and oxygen supplementation, infants with BPD experience much milder injury without necrotizing bronchiolitis or alveolar septal fibrosis. Instead, there are usually uniformly dilated acini with thin alveolar septa and little or no interstitial fibrosis. It develops most commonly in the first 4 weeks after birth.
Feeding problems are common in infants with BPD, often due to prolonged intubation. Such infants often display oral-tactile hypersensitivity (also known as oral aversion). Physical findings:
There is evidence to show that steroids given to babies less than 8 days old can prevent bronchopulmonary dysplasia. However, the risks of treatment may outweigh the benefits. It is unclear if starting steroids more than 7 days after birth is harmful or beneficial. It is thus recommended that they only be used in those who cannot be taken off of a ventilator.
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Wikipedia