Bronchopulmonary dysplasia (BPD) is a serious lung condition that develops in premature infants that require prolonged oxygen therapy, often as a complication of RDS. This is because oxygen therapy can cause damage and inflammation of the lungs, leading to BPD. The risk of developing BPD is higher the more premature the infant, and the lower the birth weight. BPD is one of the most common chronic lung diseases among children, often found in infants born less than 30 weeks old, weighing less than 1000g.
Symptoms of BPD include rapid and laboured breathing, coughing and having a bluish skin tone on the face. Infants who have had RDS and still require oxygen therapy when they reach their original due date will be diagnosed with BPD.
Causes of BPD
Premature infants with RDS are more likely to develop BPD because both ventilator support and oxygen therapy, which are required treatments to deal with RDS, can cause scarring and damage to the lungs that lead to BPD. This is because while these treatments are necessary, they are very invasive for the preemies’ delicate lungs to handle. BPD can also arise from the scarring and inflammation of the lungs from other problems face by premature infants such as trauma and infections.
Risks of BPD
Some infants with BPD may continue to have long-term lung problems, and are more susceptible to conditions such as asthma. They are also more susceptible to repeated respiratory infections. In severe cases, BPD can negatively affect the heart, growth, coordination as well as speech and learning development. Even though most infants with BPD will require months of follow-up treatment, most do get better over time.
Dealing with BPD
In dealing with BPD, support given to the infant in the NICU is targeted towards aiding their breathing so that they can grow healthier. Apart from supporting their breathing using a ventilator, they are also given medications that include bronchodilators (to keep airways open), diuretics (to reduce fluid build-up) and antibiotics (to fight infections). While the infants are slowly weaned off the ventilator, they will likely continue with oxygen therapy.
Infants with BPD also need more nutrients and calories for recovery and growth. They are usually given a high-calorie formula through a tube that is fed through the nose or mouth, into the stomach. This is because they have difficulty sucking and swallowing. This method of feeding refers to enteral feeding (or tube feeding). The formula can be supplemented with breast milk.
Once your baby is ready to go home, you likely need to continue monitoring your child’s blood oxygen level and continue their oxygen treatment. If your baby was slow to gain weight, you may need to continue enteral feeding at home. The NICU staff will brief you on what you will need to do, and when to seek medical help. While your child is recovering, it is important to practice good hygiene and keep them protected from exposure to germs and lung irritants such as cigarette smoke.
Medical homecare equipment explained:
- Pulse oximeter
A Pulse oximeter measures the amount of oxygen in the baby’s blood through the skin. A tiny light is taped to the baby’s finger or toe, or in very tiny babies, a foot or hand. A wire connects the light to the monitor where it displays the amount of oxygen in the baby’s red blood cells. Your doctor will advise you on how to interpret the readings, and when to seek medical help.
- Oxygen concentrator
This machine extracts oxygen from the air and supplies it to the baby through a nasal tube. Because this machine requires electricity to run, you may need a backup oxygen tank, just in case the power goes out. Ensure that the tubing remains clean to prevent infections.