Bronchopulmonary Dysplasia – Causes, Symptoms & Treatment
Bronchopulmonal Dysplasia
Bronchopulmonary dysplasia is a chronic lung disease. It mainly occurs in preterm infants who are born with low body weight. Bronchopulmonary dysplasia can damage the lungs long-term and into adulthood and can lead to death due to persistent changes in the lungs.
What is Bronchopulmonary Dysplasia?
Premature children are particularly affected by bronchopulmonary dysplasia. These newborns are often artificially ventilated over a longer period of time, for example to treat neonatal respiratory distress syndrome. The disease can cause long-term damage to the lungs. Depending on the degree of severity and the effectiveness of the treatment, an improvement can often be achieved in the course of the first year of life.
causes
Bronchopulmonary dysplasia can have various causes. In most cases there is a close connection between the time the children were born. The earlier they are born and the lower their birth weight, the more common bronchopulmonary dysplasia occurs. Premature babies whose birth weight is less than 1000 grams or who are born before the 32nd week of pregnancy suffer from 15 to 30 percent of bronchopulmonary dysplasia.
A major risk factor for the development of bronchopulmonary dysplasia is an immature lung with a deficiency of the substance surfactant. Other factors are high ventilation pressure, high oxygen concentrations and a long duration of artificial ventilation. An open ductus arteriosus and various infections of the lungs can also be the cause of bronchopulmonary dysplasia.
The disease is caused by remodeling processes that are associated with inflammation in the connective tissue. Such inflammatory processes can occur as a result of initial water retention in the immature lungs or chemical, mechanical and biological damage.
Symptoms, Ailments & Signs
In the context of bronchopulmonary dysplasia, various symptoms can occur in the affected patients. Possible clinical symptoms include, for example, an increased respiratory rate , increased bronchial secretion, deep and labored breathing with constriction of the chest, coughing and growth retardation . Livid areas on the skin and mucous membrane can also appear.
The lung shows, among other things, diffuse areas of hyperinflation and poorly ventilated areas, which show up in the X-ray image . Bronchopulmonary dysplasia is divided into mild, moderate and severe forms. Bronchopulmonary dysplasia primarily affects the alveoli, the blood vessels in the lungs and the respiratory tract. The blood vessels in the lungs narrow and can increase the pressure in the pulmonary circulation and put strain on the right ventricle of the heart.
Diagnosis & History
The diagnosis of bronchopulmonary dysplasia and the categorization into different degrees of severity of the disease is carried out by determining the oxygen saturation in the blood. A necessary oxygen requirement is defined for every age, which can provide information about the presence of bronchopulmonary dysplasia. As a rule, the oxygen requirement of the age, which is corrected by 36 weeks of pregnancy, is decisive.
The prognosis for bronchopulmonary dysplasia is improving. Due to advances in medical research and care, premature babies have an increasing chance of surviving. Today, about 60 percent of all children born during the 24th and 25th week of pregnancy survive. Because their lungs are immature in most cases, they need to be ventilated for long periods of time to get enough oxygen.
complications
Bronchopulmonary dysplasia is the most common complication in newborns. Infants affected by the disease often breathe too rapidly. As a result, shortness of breath can easily occur, leading to a lack of oxygen. Due to the lack of oxygen in the blood, the skin turns bluish (cyanosis).
The increased respiratory rate can also lead to cardiac arrhythmia and overloading of the right ventricle. In some preterm infants with bronchopulmonary dysplasia, exhalation slows, causing the air remaining in the lungs to overinflate the alveoli. A scarring transformation of individual lung areas threatens as a complication.
The late effects of the disease include recurrent respiratory infections, in particular pneumonia or acute bronchitis. Parents should therefore take care to keep the risk of infection for the affected children as low as possible. Due to the damaged bronchial system, there is also a risk of developing bronchial asthma.
If fluid accumulates in the lung tissue, pulmonary edema can occur. A feared consequence of bronchopulmonary dysplasia is pulmonary hypertension. When the oxygen exchange in the lungs is reduced, the blood builds up in the pulmonary circulation. This leads to an enlargement of the right ventricle, cor pulmonale.
When should you go to the doctor?
In most cases, this disease is diagnosed immediately after the birth of the child. Treatment should take place at a very early age to avoid complications and premature death of the child. A doctor should always be consulted for this complaint if various breathing difficulties occur. Those affected suffer from loud and unnatural breathing noises and in many cases also from a significantly increased breathing rate.
Since the body is supplied with little oxygen, the lips and skin can turn blue. If you have these symptoms, you should definitely see a doctor. In many cases, the patient’s resilience and endurance also decrease significantly. Furthermore, children suffer from delays in growth and development. If these delays occur, a doctor must also be consulted. The treatment of this condition and the possible compilations is usually carried out by a specialist. The diagnosis itself is made with the help of an X-ray.
Treatment & Therapy
The most important measure in the treatment of bronchopulmonary dysplasia is the administration of oxygen to maintain the oxygen saturation in the blood. The desired oxygen content is over 92 percent. In addition, the affected patient is prescribed corticosteroids , which must be administered both systemically and inhaled.
These counteract the chronic inflammatory process, but should not be used uncritically due to potential side effects. Possible complications include, for example , hyperglycaemia , intestinal bleeding, stomach ulcers or the development of osteoporosis . Any pulmonary edema that may occur is treated with draining drugs, so-called diuretics .
If the airways are narrowed, inhalation with bronchospasmolytics must be considered. In addition, physiotherapeutic treatments are appropriate, which are carried out early and regularly if possible. The increased pressure of the pulmonary circulation can be treated with the help of vasodilating drugs.
In addition, due to the increased energy requirements of the affected children, attention must be paid to nutrition. It should be particularly energetic. Before the patients suffering from bronchopulmonary dysplasia can be discharged from the clinic, the first vaccinations, for example against whooping cough and pneumococcal infections, should be carried out.
Outlook & Forecast
In the worst case, this disease can lead to the death of the affected person. This case occurs especially when the condition is completely ignored and left untreated. With treatment, the damage to the lungs can be alleviated, although complete healing is impossible. The further course and life expectancy also depend heavily on the exact form of the disease, so that a general prediction is usually not possible.
In most cases, however, the life expectancy of those affected is significantly reduced by the disease. The treatment itself depends on the symptoms and is intended to limit the inflammation. If no treatment is initiated, the inflammation will spread throughout the patient’s body and continue to deteriorate the patient’s health.
Patients are also dependent on taking medication, which is often associated with severe side effects. Vaccination can prevent further infections and complications. Furthermore, the disease can also lead to severe psychological complaints, which can occur not only in the patient himself, but also in the parents or relatives. They are therefore also dependent on psychological treatment.
prevention
Measures to prevent bronchopulmonary dysplasia exist, but they have different effectiveness or are difficult to implement. Possible preventive measures include avoiding premature births and prenatal lung maturation by administering corticosteroids to the mother-to-be. In addition, it is essential to avoid infections and to carry out artificial respiration as briefly and gently as possible.
Therapy with systemic corticosteroids, for example in the form of dexamethasone, can bring about a rapid improvement in lung function. If administered very early, the probability of the development of bronchopulmonary dysplasia can be reduced. Here, the side effects of the drugs used to prevent bronchopulmonary dysplasia must be weighed up through early administration.
aftercare
As a rule, the person affected by this disease is dependent on a very early and, above all, comprehensive diagnosis, so that there are no further symptoms or complications. If the disease is not treated or not recognized until late, it can, in the worst case, lead to the death of the person affected. For this reason, the focus of this disease is on early diagnosis with subsequent treatment.
In most cases, the treatment is carried out with the help of medication. Those affected are dependent on regular intake, whereby care must be taken to ensure the correct dosage. If you have any questions or are unclear, you should always contact a doctor first. Furthermore, most of those affected are also dependent on physiotherapy measures to relieve the symptoms permanently.
Many exercises from such a therapy can also be done at home. The support and care provided by parents and relatives can also have a positive effect on the further course of the disease. The person concerned should protect themselves particularly well against infections. In most cases, this disease reduces the life expectancy of the patient.
You can do that yourself
Bronchopulmonary dysplasia affects newborns born before 26 weeks gestation. These have to be artificially ventilated because the lungs are not yet fully developed. This can permanently damage the lungs.
Shortly after the birth of their premature child, parents should give the child intensive attention and tenderness as part of their self-help. This type of presence can already strengthen the immune system in the first days of life to such an extent that the chance of survival is increased enormously. Within the first year of life, but also in the years that follow, the therapy plan drawn up for the child must be strictly adhered to.
Staying in the fresh air and a healthy diet have a positive effect on the child’s circulation and lung function. Since the risk of infection in kindergarten and school is particularly high for children with bronchopulmonary dysplasia, parents should strengthen their child’s immune system with a balanced diet rich in vitamins.
Furthermore, the child’s home environment should be clean and hygienic to reduce the risk of infection. Over the years, bronchial asthma can develop. It is recommended that adult patients with this syndrome also take the self-help measures already mentioned and lead a healthy lifestyle with gentle exercise.
Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.