Bronchopulmonary dysplasia

Background

Lobes of the lung with related anatomy.
A - Alveoli AS - Septum alveolare BR - Bronchus respiratorius BT - Bronchus terminalis D - Mucous gland DA - Ductus alveolaris M - Musculus N - Nervus PA - Branch of Arteria pulm. PV - Branch of Vena pulm.
  • Chronic lung disease that develops in premature infants who require prolonged mechanical ventilation and/or supplementary oxygen, usually due to respiratory distress syndrome
  • Develops within first 4 weeks of life while infant still in NICU
  • Typically lung function improves with time, but many require long term O2 supplementation or other therapy

Clinical Features

  • May be asymptomatic until something (e.g. infection, respiratory irritant) triggers decompensation
  • SOB
  • Hypoxia
  • Increased respiratory secretions
  • Wheezing, crackles
  • +/- pulmonary hypertension
  • Poor feeding

Differential Diagnosis

Pediatric Wheezing

Pediatric Shortness of Breath

Pulmonary/airway

Cardiac

Other diseases with abnormal respiration

Evaluation

CXR of a patient with of bronchopulmonary dysplasia.
  • Typically not an ED diagnosis
  • Evaluate for precipitants of decompensation (e.g. infectious workup etc.)
  • CXR
    • Hyperinflation, low diaphragm, atelectasis, cystic changes

Management

Disposition

  • Low threshold to admit for acute respiratory symptoms

See Also

External Links

References