BPD Flashcards
What is Bronchopulmonary Dysplasia (BPD)?
A chronic lung disease occurring in roughly 10,000–15,000 infants per year in the US, most commonly in prematurely born infants who required mechanical ventilation and oxygen therapy for acute respiratory distress.
What characterizes Classic BPD?
Prominent fibroproliferation.
What characterizes New BPD?
Develops in preterm newborns with minimal or no ventilatory support and low inspired oxygen concentrations, showing more uniform and milder regions of injury.
What is the current definition of BPD based on?
Oxygen requirement at 28 days or 36 weeks corrected gestational age.
What is a potential advantage of the new definition of BPD?
It may be predictive of long-term pulmonary morbidity.
What is the primary risk factor for BPD?
Pulmonary immaturity.
What are the three key pathogenic factors of BPD?
- Lung immaturity
- Acute lung injury
- Inadequate repair of the initial lung injury.
What is the incidence of BPD for infants born at 22 weeks?
85%.
What is the incidence of BPD for infants born at 28 weeks?
23%.
What endogenous factors are linked with BPD?
- Gestational immaturity
- Lower birth weight
- Male sex
- White or nonblack race
- Family history of asthma
- Small for gestational age
- Genetic susceptibility.
What are key prenatal factors for the risk of BPD?
- Maternal smoking
- Preeclampsia
- Placental abnormalities
- Chorioamnionitis
- Intrauterine growth restriction.
What are some postnatal factors contributing to BPD?
- Lower Apgar scores
- RDS
- PDA
- Higher weight-adjusted fluid intake
- Duration of oxygen therapy.
What is ‘volutrauma’ in the context of BPD?
Phasic stretch or overdistention of the lung that can induce lung inflammation and structural changes mimicking BPD.
What effect does oxygen toxicity have on preterm infants?
Increases production of reactive oxygen species (ROS), promoting lung inflammation and impairing alveolar and vascular growth.
What role does inflammation play in the development of BPD?
Induced by oxygen toxicity, volutrauma, and infection, leading to the release of proinflammatory cytokines.
What is the impact of chorioamnionitis on lung development?
It disrupts alveolar and vascular development, decreasing alveolar number and potentially leading to pulmonary hypertension.
What are the respiratory function characteristics in established BPD?
Primarily characterized by reduced surface area and heterogeneous lung units, leading to variable time constants throughout the lung.
What are the common imaging findings in BPD?
- Diffuse haziness
- Hyperinflation
- Air trapping
- Fibrosis.
What are the laboratory findings associated with BPD?
- Hypercarbia
- Elevated bicarbonate levels
- Increased IL-1β, IL-6, IL-8, IL-10, and interferon-γ.
What is a common echocardiographic finding in infants with BPD?
Evidence of pulmonary hypertension (PH).
What is the role of antenatal steroids in preventing BPD?
They have reduced the incidence of neonatal death and RDS but failed to decrease the incidence of BPD.
What is the mainstay of therapy for infants with BPD?
Supplemental oxygen.
What are the effects of diuretics in the treatment of BPD?
Reduce lung edema and improve pulmonary compliance and airway resistance.
What is the goal for oxygen saturation levels in infants with BPD?
Maintaining saturation levels above 92%–94%.
