Bronchopulmonary Dysplasia: Causes, Symptoms, and Management

Introduction

Bronchopulmonary dysplasia is a chronic lung condition that affects children, especially newborns. Premature babies born before ten weeks of the delivery date are more prone to this lung condition. Preterm birth newborns with weights less than two pounds are also affected by bronchopulmonary dysplasia due to incomplete lung development. This is not a congenital condition, as it occurs after birth.

What Is Bronchopulmonary Dysplasia?

Bronchopulmonary dysplasia causes long-term breathing problems in premature dysplasia. This condition often results in poor growth and development. There is no cure for this condition, but it can be treated, and most babies live long and healthy lives.

What Are the Causes of Bronchopulmonary Dysplasia?

• Lung Disorder: Premature babies born with previously existing lung diseases like respiratory distress syndrome or undeveloped lungs are affected by bronchopulmonary dysplasia.

• Steroids: Premature babies born without receiving steroids are at increased risk of bronchopulmonary dysplasia.

• Oxygen Insufficiency: The newborns with oxygen deprivation during birth require ventilatory support for breathing.

• Family History: The genetic inheritance of lung abnormality causes bronchopulmonary dysplasia.

• Nutritional Deficiency: Premature newborns have nutritional deficiencies and immunity disorders. They are likely to acquire respiratory illnesses or microbial infections faster.

• Pregnancy: The conditions that affect newborns during pregnancy include preeclampsia (increased blood pressure) and infections.

What Are the Symptoms of Bronchopulmonary Dysplasia in Newborns?

Every newborn is different and has its symptoms. The symptoms vary depending on the severity of bronchopulmonary dysplasia and the time of premature birth. The few symptoms are as follows;

• Respiratory Illness: The babies born with respiratory ailments lead to bronchopulmonary dysplasia at the 36th week. The newborn has breathing problems with the flaring of the nostrils.

• Cardiac Problems: The newborns have irregular heartbeats, which can eventually lead to heart failure. The newborn pulls the chest during each respiratory cycle.

• Feeding: It is difficult to feed newborns, as they throw tantrums due to breathing problems. The newborn's breathing is rapid and shallow.

• Growth: There is a developmental delay in the organs and parts of the body. Height and weight are underdeveloped in premature babies compared to normal babies.

• Sensory Problems: The babies have problems with their vision and hearing. Grunting sounds are heard during breathing due to lung defects.

What Are the Stages of Bronchopulmonary Dysplasia in Newborns?

Based on the progress of the disease in bronchopulmonary dysplasia, it is classified into four stages. They are as follows;

• Stage 1: The initial stage is also known as respiratory distress syndrome. In this stage, the newborn is unable to get enough oxygen during breathing, which eventually leads to bronchopulmonary dysplasia.

• Stage 2: The frequent inhalation of oxygen from the ventilators damages the alveoli (tiny air sacs), damages the lungs, and results in swelling in the lung tissue.

• Stages 3 and 4: These stages have severe long-term symptoms. Newborns have inflammation in the blood vessels of the lungs (pulmonary vessels). The oxygen-carrying capacity is reduced in newborns due to the rupture of blood vessels. This eventually increases blood pressure and causes pulmonary hypertension.

How Is Bronchopulmonary Dysplasia Diagnosed in Newborns?

The pediatricians decide on the diagnostic test based on the problem associated with lung development. The diagnostic tests are as follows;

• Chest X-Rays: X-rays are taken for babies with bronchopulmonary dysplasia to observe the condition of the lungs, airways, ribs, and chest.

• Pulse Oximeter: The pulse oximetry test measures the oxygen level in newborns' blood, which is useful for assessing lung function.

• Arterial Blood Gas Test: An arterial blood gas test measures the pH, oxygen, and carbon dioxide levels in the bloodstream. Any alterations in the blood acidity level reveal an abnormality in the newborn's lungs.

What Are the Various Treatment Methods for Newborns With Bronchopulmonary Dysplasia?

If premature delivery is necessary, then treat the pregnant woman with steroids to avoid the risk of bronchopulmonary dysplasia. Though bronchopulmonary dysplasia cannot be cured completely, the symptoms can be managed with the help of the following measures;

• Healthy Intake: Premature babies require nutrition and 140 to 150 calories daily. Breast milk boosts immunity and improves lung conditions, so formulated breast milk must be provided for underweight babies to prevent bronchopulmonary dysplasia.

• Avoid Fluids: Try to restrict the fluid intake of infants because it reduces swelling in the lung tissue. Excess fluid around the lungs of newborns results in lung collapse. So avoid excess fluids.

• Ventilatory Support: The baby cannot breathe due to lung abnormalities. The oxygen is provided by ventilators in hospitals. After discharge, the baby might require ventilator support in the home as well. The medical provider uses a less invasive technique to deliver oxygen to avoid injury to the newborn's airways.

• Medications: Bronchodilators open the air passages and facilitate breathing in newborns. An artificial surfactant prevents lung collapse in infants by preventing the rupture of the small air sacs (alveoli). Medical professionals prescribe diuretics to reduce fluid accumulation around the lungs. Untreated bronchopulmonary dysplasia in newborns is life-threatening.

How to Prevent Lung Disorders in Newborns?

Pregnant women should take good prenatal care for the welfare of the baby.

• A healthy pregnancy can avoid premature birth and lower the risk of respiratory illnesses.

• A pregnant mother should get a healthy diet and avoid smoking alcohol or cocaine until delivery.

• Pregnant women with lung issues or any other medical conditions must take prior treatments as it influence bronchopulmonary dysplasia in newborns.

• Apart from bronchopulmonary dysplasia, the underlying lung diseases must be identified in newborns and treated earlier to avoid future complications.

Conclusion:

In most cases, newborns are admitted and treated in the hospital until recovery to avoid breathing problems. Due to awareness, the prevalence rate of bronchopulmonary dysplasia has recently been reduced. The appropriate treatment at the initial stages can increase the survival rate of premature babies. The parents and pediatrician must observe developmental delays and symptoms periodically.