What Is Bronchopulmonary Dysplasia: 7 Key Facts

What is bronchopulmonary dysplasia BPD-  Bronchopulmonary dysplasia (BPD) is respiratory distress syndrome, also known as Chronic lung disease. ¹In this chronic lung disease, the infant’s lungs or the baby’s lungs become irritated, and the baby’s lung is not developed as normal.

This chronic lung disease is prevalent in premature infants who require oxygen therapy or a mechanical ventilator for survival. Premature infants are infants with low birth weight or are born before time. Such a baby’s lungs are not fully developed and need oxygen therapy for breathing.

Bronchopulmonary dysplasia ²BPD or the pulmonary disorder is also called Chronic lung disease of premature babies, chronic lung disease of infancy, Neonatal chronic lung disease³, and Respiratory distress syndrome.⁴

What Is Bronchopulmonary Dysplasia

Bronchopulmonary dysplasia is a long-term disorder. Bronchopulmonary disorder is a chronic lung disease that mostly affects newborn babies, especially who are born prematurely. Those premature babies need breathing machines. Sometimes those machines will provide extra oxygen to the babies, and the baby will develop this disease.

Premature babies need those machines because their lungs are not developed properly. The main signs and symptoms are wheezing sounds, shortness of breath, and pauses in breathing patterns. The doctor suggests the diagnosis tests like echocardiogram, chest X-ray, MRI, and CT scan.

There are many basic and advanced treatments for this disease or disorder, but it is difficult to cure it completely. The child will experience some problems even when they are grown up, but after the treatment, the person suffering from this disorder can live a healthy and long life.

I will tell you that 10,000 infants in the United States develop BPD yearly.

1. Causes Of Bronchopulmonary Dysplasia BPD

In most cases, bronchopulmonary dysplasia is caused when extra oxygen is provided to a premature baby with the help of breathing machines like a mechanical ventilator. This mostly happens when the baby is born too early so that his lungs are not fully grown, and they are not able to breathe properly, so they need breathing machines.

These machines can provide oxygen to the baby, but the oxygen is given under pressure, so sometimes it hurts the air sacs of the lungs, and the baby will develop BPD.

2. Signs And Symptoms Of Bronchopulmonary Dysplasia BPD

The baby having this respiratory distress syndrome needs oxygen therapy or a mechanical ventilator in the starting few days for survival. But now, how can we identify whether this baby or infant is suffering from Bronchopulmonary dysplasia BPD or has any respiratory infections?

So, here are some signs and symptoms by which the doctor or we can identify the condition of bronchopulmonary dysplasia BPD. The signs and symptoms include.

• They face pulmonary hypertension.

• Premature babies having bronchopulmonary dysplasia BPD or this respiratory distress syndrome are not able to breathe fast and as much as required.

• The babies or infants having these respiratory infections pause their breathing patterns for a few seconds.

• Nostrils flare while breathing in such a breathing disorder because it impacts pressure on a newborn’s delicate lungs.

• Wheezing sound is also observed in bronchopulmonary dysplasia BPD.

• In this pulmonary disease, skin pulling between the ribs or collar bones is also observed.

• Due to not proper lung function in newborn’s lungs, in severe BPD, it turns into bluish color while crying because of insufficient oxygen.

Suppose any of the above symptoms are observed in the baby or the premature baby. In that case, the infant suffers from bronchopulmonary dysplasia and needs a breathing machine or mechanical ventilation for breathing assistance.

In most babies or babies born prematurely, this condition is common. Still, apart from this, other factors include placental abnormalities, patent ductus arteriosus, fetal membranes blood vessels destruction, respiratory infection, abnormal development of the fetus, uneven lung development, bacterial infections, maternal complications, lung injury, small air sacs development, irregular blood flow, and genetic factors also cause this bronchopulmonary dysplasia in newborns.

They need continuous mechanical ventilation for extra oxygen. This continuous ventilation and breathing treatments help the infants recover and also help control infections until full lung development.

3. Diagnose BPD

Bronchopulmonary dysplasia or any breathing disorder needs intensive medical care and a breathing machine, including a breathing tube. This disorder is observed in the hospital only when a child with breathing difficulties or damaged lung tissue is born. Most babies born prematurely or with lung tissue or lung damage are likely to develop BPD to identify.

The intensive medical care team observes the normal lung function, child breathing problems, underdeveloped lungs, and other risk factors, including fighting bacterial infections, high blood pressure, tobacco smoke, and birth weight. For confirmation, several tests, including blood tests and other tests, are suggested.

3.01. Chest X-Ray, MRI, And CT Scan

Babies facing breathing problems or any effects newborns developing BPD⁵ are recommended for the Chest X-Ray, MRI, or CT Scan. These reports help the doctor see if a premature baby’s lungs are growing. So observe the child’s lung status more deeply.

3.02. Blood Tests

Blood tests are recommended to find out the respiratory syncytial virus in severe cases who develop BPD after normal weight.

3.03. Echocardiogram

Going for treatment, including surfactant replacement therapy or bronchopulmonary dysplasia treatment, doctors must be sure that the preterm infants are infected with bronchopulmonary dysplasia only. If the breathing problems remain and a breathing tube is necessary, the doctors advise the Echocardiogram.

An echocardiogram is just like an ultrasound test, and it helps the doctor to see or view the heart and find the exact heart problem in the child’s lungs.

4. Treatment Of Bronchopulmonary Dysplasia

Many treatments are given to the baby after lung damage to treat this disease. The main aim of these treatments is to heal the lung damage and help them to grow properly.

Bronchopulmonary dysplasia can be treated with the following treatments if a baby develops bronchopulmonary dysplasia.

4.01. Breathing Machine

The baby needs a tracheostomy. Do you know what tracheostomy is? Tracheostomy is a method by which a breathing tube is placed surgically in the baby’s windpipe so that the baby will breathe properly. If the baby’s lungs are not very well developed, mechanical ventilation is not a good option.

This method is used because it provides oxygen with less pressure to the baby so that, with time, the baby’s lungs will heal and grow.

4.02. Nutrition Therapy

Sometimes babies will not get the proper nutrition, and we don’t know about it. So it isn’t easy to know whether the baby is getting proper nutrients. And the baby is suffering from bronchopulmonary dysplasia, so it becomes more important for the baby to get proper nutrients to treat the disease.

So, the doctors use a different method to give nutrition directly to the stomach. It is done by the Gastrostomy Tube method, also known as a G-tube. In this method, a tube is surgically inserted into the baby’s stomach through the wall of the abdomen.

By this tube, air and fluid are directly transferred to the stomach. This tube is used to give liquid fluids and drugs to the baby.

4.03. Proper Oxygen Therapy

The baby will get the proper amount of oxygen without any pressure so the lungs can develop properly. The doctors use some medication or machines so that the baby will get proper oxygen and the lungs can heal and grow properly.

Medications

Most infants who cannot heal their lungs with oxygen therapy, G Tube method, and tracheostomy are treated with some medications. So that their lungs are healed, and they will grow properly.

1. Diuretics- Diuretics are given to like reduce the fluid build-up in the lungs. It is because, in this disease, the fluid overloads the baby’s lungs, which is difficult to reduce. So, doctors take the help of diuretics to reduce the fluid from the baby’s lungs.

2. Bronchodilators- Bronchodilators open the airways of the lungs so that airflow is maintained properly in the baby’s lungs. Due to the disease, the baby’s muscles got banded, tightening themselves around the airways, reducing airflow. So, to treat the disease, it is very important to open the airways to maintain the proper flow of air.

3. Pulmonary Vasodilators- Pulmonary vasodilators are used to reduce the pulmonary artery pressure to maintain the proper blood flow to the lungs. If the pulmonary artery is facing so much pressure, proper blood flow is impossible. If the blood flow is improper, the baby will develop some more diseases.

4. Steroids are given to babies to reduce inflammation because steroids have anti-inflammation properties. And it also helps in reducing the swelling in the lungs.

5. Antibiotics- Infants have a very weak immune system, and any virus or bacteria can easily cause any disease, especially in cases when they are already suffering from bronchopulmonary dysplasia. So antibiotics are given to them to control all types of infection. The baby suffering from bronchopulmonary dysplasia has a major risk of pneumonia. ⁶So, antibiotics are given to the babies to prevent pneumonia and other infections.

5. Some Disorders Related To Bronchopulmonary Dysplasia

There are some disorders that the baby will develop if he is suffering from bronchopulmonary dysplasia. We will discuss some of these diseases in detail.

5.01. Pulmonary Hypertension

This is a disease that is caused by high blood pressure that affects the arteries of the lungs along with the right side of the heart. This disease is also known as Pulmonary Arterial Hypertension (PAH).

In this disease, the blood vessels are narrowed first, and they are blocked and destroyed after some time. Due to that, the blood flow in the lungs is slowed down, and the pressure increases on the lung arteries. So the heart has to pump blood with more pressure which makes heart muscles weak, and sometimes they fail to do their function.

With proper treatment and medication, the symptoms of this disease are reduced, but it is difficult to cure this disease completely.

5.02. Respiratory Distress Syndrome (RDS)

Respiratory distress syndrome in short RDS is also known as HMD (Hyaline Membrane Disease⁷). This disease is caused in premature infants. This disease respiratory distress syndrome is caused by the deficiency of surfactant in the lungs. During pregnancy, the fetus will start making surfactant in the third trimester, which starts after the 26th week of pregnancy.

Surfactant is a foamy substance. The function of surfactant is to keep the lungs fully expanded. The fully expanded lungs help the baby to breathe properly. The symptoms of RDS are low blood pressure, shortness of breath, extreme tiredness, and rapid breathing rate.

6. Risk Factors For Babies Developing BPD

There are many risk factors for a baby who is suffering from BPD. We will discuss some of the risk factors.

• The baby is born earlier than the actual time. The baby will take birth around 2 months earlier than the delivery time.

• The baby is very weak, and the baby’s weight is less than 2.2 pounds.

• The baby is more likely to develop respiratory distress syndrome.

• The baby is more likely to develop heart disease due to pulmonary hypertension.

• The baby is very weak, so the baby’s immune system is also very weak, so the baby will develop other infections.

• Sometimes this disease leads to immaturity and growth retardation in the babies.

• The pulmonary structure of the lungs is destructed due to bronchopulmonary dysplasia.

• This disease also causes fibrosis, which means the tissue thickens so the baby cannot breathe properly and feels a shortening breath.

7. Long-Term Complications Of Bronchopulmonary Dysplasia

Many infants suffering from BPD in childhood may experience many diseases and complications. Some of them include:

• The child can face many breathing problems even when they are grown up.

• The child suffering from BPD is at higher risk of catching or suffering from a cold or flu.

• The child may need oxygen therapy or breathing support even when he leaves the hospital.

• The immune system of the child will become weak.

• It causes problems in the development and growth of the child. The child will face delayed growth, especially in the starting years.

• The child can experience problems swallowing the food.

• The child can experience some symptoms similar to asthma.

• The child can develop central airway disease and sleep hypoxemia.

8. Recent Researches On Bronchopulmonary Dysplasia

In recent years, stem cell technology has become very advanced, and we can treat many diseases by using this technology. So, recently researchers have been trying to develop a new treatment for this disease by using the lung epithelial progenitor cells. They focus on the formation of alveolar microvascular, tissue maintenance, and repairing and regeneration of lungs.

They have already started the lung budding and developing pulmonary vascular endothelium cells. The multipotent mesenchymal cells will give rise to the vascular smooth muscle and early fibroblast cells. During the development of the alveolar lung, the mesenchymal cells will develop lip fibroblasts and myofibroblasts, which are very important for alveolar development.⁸

This research is done on neonatal mice, but as soon as possible clinical trials will start for this disease. As stem cell technology works properly, infants fully recover from BPD. It only takes several weeks to cure the disease completely, and the baby will not face any long-term complications.

The research started on the neonatal rat hyperoxia model of BPD. There is another therapy by which we can treat this disease in the future, which is Potential Therapy. It is a cell-based therapy.

Another method by which BPD can be treated in the future is pulmonary macrophages because pulmonary macrophages will develop alveolar development and repair. Along with this, many types of research are started on anti-inflammatory agents. Recently research has been started on Interleukin 1 receptor antagonists and intra-amniotic fluid. After some time, the clinical trials will start for these anti-inflammatory agents and as soon the clinical trials get successful, we can use these medications to treat BPD.

Final Note

What Is Bronchopulmonary Dysplasia- In this article, we have discussed the disease BPD. According to the article, BPD is a chronic lung disease that affects newborns, especially who have taken birth prematurely. It is because those babies’ lungs cannot respirate properly. So, they need some machines that will provide them with the proper amount of oxygen, but sometimes those machines provide extra oxygen because the baby suffers from BPD.

Those babies show some signs and symptoms that parents or doctors should observe. After observing those symptoms, the doctor will advise some diagnostic tests, and if the test results are positive, the doctor starts the treatment of the baby. After treatment, the child may face some complications because this disease is not completely cured.

The information provided in this article is a collection of many resources; this article will help you determine if the person is suffering from Bronchopulmonary dysplasia  BPD or not. If you face any such health issues, contact your doctor as soon as possible. 

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Last Updated on July 24, 2024 by Sathi Chakraborty, MSc Biology