Bronchopulmonary dysplasia

Question 1

What is bronchopulmonary dysplasia?

Answer 1

Long term lung dysfunction in premature babies

Question 2

What are the major risk factors for bronchopulmonary dysplasia?

Answer 2

Maternal smoking & intrauterine growth restriction

Question 3

How is bronchopulmonary dysplasia diagnosed?

Answer 3

Made when infant requires oxygen beyond 36 weeks of age

Question 4

What is the pathophysiology of bronchopulmonary dysplasia?

Answer 4

Lung inflammation, oxidative stress and growth factors contribute- the lungs undergo abnormal repair and remodelling leading to changes which impair lung function

Question 5

What are the clinical features of bronchopulmonary dysplasia?

Answer 5

1. Low O2 sats
2. Increased work of breathing
3. Poor feeding & weight gain
4. Crackles & wheezes on chest auscultation
5. Increased susceptibility to infection

Question 6

How can bronchopulmonary dysplasia be prevented?

Answer 6

Corticosteroids given to mothers with signs of premature labour at less than 35 weeks which speeds up fetal lung development to reduce the risk

Question 7

What can reduce the risk of bronchopulmonary dysplasia?

Answer 7

1. Using CPAP rather than intubation & ventilation
2. Using caffeine
3. Not over-oxygenating with supplemental O2

Question 8

What is the management for bronchopulmonary dysplasia?

Answer 8

1. Overnight oximetry study to record O2 sats during sleep & guide management
2. Discharged on home oxygen which is slowly weaned
3. Monthly palivizumab injections to protect against RSV and bronchiolitis