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bronchopulmonary dysplasia
chronic lung disease of babies
Pathology:
- environmental injury (hypothesis)
Clinical manifestations:
1) develops most commonly in the first 4 weeks after birth
2) mostly occurs in babies who are born more than 4 weeks before their due dates
3) sometimes the babies are full term
4) babies have trouble breathing
Management:
1) supplmental oxygen
2) mechanical ventilation may be necessary
3) high-dose dexamethasone (0.5 mg/kg daily) to prevent or treat bronchopulmonary dysplasia in preterm infants of no benefit & may be harmful [1]
- inhaled budesonide for prevention in preterm infants
- does not prevent neurodevelopmental disability [3]
- increases mortality [3]
4) enteral supplementation with docosahexaenoic acid does not improve respiratory outcomes (bronchopulmonary dysplasia) for extremely premature infants [2]
5) prognosis
a) most babies live
b) in severe cases, a baby may die
General
developmental disorder
lung disease
References
- Choosing Wisely
American Academy of Pediatrics
Ten Things Physicians and Patients Should Question.
http://www.choosingwisely.org/doctor-patient-lists/american-academy-of-pediatrics/
- Collins CT et al.
Docosahexaenoic acid and bronchopulmonary dysplasia in preterm
infants.
N Engl J Med 2017 Mar 30; 376:1245
PMID: 28355511
http://www.nejm.org/doi/10.1056/NEJMoa1611942
- Bassler D, Shinwell ES, Hallman M et al
Long-Term Effects of Inhaled Budesonide for Bronchopulmonary
Dysplasia.
N Engl J Med 2018; 378:148-157. January 11, 2018
PMID: 29320647
http://www.nejm.org/doi/full/10.1056/NEJMoa1708831
- What Is Bronchopulmonary Dysplasia ?
http://www.nhlbi.nih.gov/health/dci/Diseases/Bpd/Bpd_WhatIs.html