What Is Chronic Lung Disease?
Chronic lung disease is a disorder that affects the lungs and other parts of the respiratory tract. The development of chronic lung disease is slow and gets worse with time. Chronic lung diseases may be caused due to environmental factors such as pollutants, allergens, etc, or may be due to smoking, tobacco, etc. The types of chronic lung diseases include asthma, Chronic obstructive pulmonary disorder, pulmonary fibrosis asbestosis, bronchopulmonary dysplasia, etc.
What Is Bronchopulmonary Dysplasia?
Bronchopulmonary dysplasia (BPD), or Chronic lung disease, is a condition seen in small babies. It is associated with the development of lung tissue in the baby. Premature babies or babies born too early(10 weeks before their due date, weight less than 2 pounds at birth) or who face difficulty breathing after birth are at higher risk of this disease. It is seen that most babies get cured on their own with few long, long-term health issues, while some need intensive medical care.
What Happens in Bronchopulmonary Dysplasia?
Bronchopulmonary dysplasia is not present in infants by birth. This disease occurs due to prolonged exposure of the child to the breathing machine or when he/she is on oxygen for a longer time. This can lead to serious lung damage by causing inflammation(swelling and irritation) and scarring. This results in the improper development of the lungs. This is most commonly seen in premature babies.
When a child faces breathing difficulty after birth, they are provided mechanical ventilation. They do the breathing artificially for a child who is unable to breathe on their own. A tube is inserted into a child's trachea(windpipe) through which they receive oxygen. The machine exerts pressure to push air into the baby’s stiff, underdeveloped lungs. Sometimes, a child may not need a tube but extra oxygen and pressure. To send oxygen and pressure into the baby’s lungs, the doctors also use nasal prongs.
When these babies require oxygen in higher concentration, the pressure exerted by mechanical ventilation on their delicate lungs results in causing injury to their lungs. These injuries, when present for a longer period of time, can hinder the normal growth of the lungs. Therefore these babies continue to have breathing difficulties and require extra oxygen for their lungs. Bronchopulmonary dysplasia is seen in premature babies who need oxygen therapy for more than 28 days.
In some cases, bronchopulmonary dysplasia can also be seen in babies whose lungs are affected by other issues such as birth defects, heart issues, pneumonia, and other infections. These issues can cause inflammation and scarring even in full-term newborns.
What Are the Causes of BPD?
The main causes of BPD are-
1 Underdeveloped lungs when the baby was in the mother’s womb
2 Pre-mature delivery
3 Long-term treatment of breathing difficulties
4 Infections such as sepsis
5 Inflammation of the lungs presents before birth could due to bacterial infection in the placenta known as chorioamnionitis.
How Does BPD Affect the Health of the Child?
It can affect a child's health in many ways, such as.
Trouble feeding, which could possibly result in a feeding tube requirement.
Gastroesophageal reflux disease (GERD) is when acid in the stomach flows back into the tube that connects the mouth to the stomach(esophagus).
Pulmonary hypertension is also seen. It elevates the pressure in the pulmonary artery(the blood vessels that carry blood from the lungs to the heart).
Delayed speech
Learning difficulties
Infections like sepsis
Heart defects can also be caused.
How Is BPD Diagnosed?
A few parameters that are considered to diagnose BPD are-
. How early was a child born?
. Levels of oxygen that the baby requires
. For how long the baby gets oxygen therapy
. The pressure exerted to flow air into the lungs of the baby
Chest X-rays and CT scans can also help doctors determine the presence of BPD and the severity of the same.
How Is BPD Treated?
The treatment of BPD is determined as per the underlying cause.
The first and foremost thing to be done is to provide breathing support and minimize lung damage. Babies get intensive care in the hospital, especially in the neonatal care units. Treatment of BPD is as follows-
1 Nasal continuous airway pressure(nCPAP)- This device helps provide breathing support by gently pushing oxygen into the child's lungs through nasal prongs.
2 Surfactant replacement therapy- Giving the infant surfactant(a thin foamy layer made of proteins and fat) requires using a breathing tube. This is given if an infant struggles to breathe even after providing CPAP.
3 Medication- Certain medications are recommended to treat BPD, which helps in the proper working of the lungs. These include-
Bronchodilators- They help maintain the airway to remain open.
Diuretics- These are used to reduce fluid buildup in the lungs.
Steroids- These are used to reduce the inflammation caused to the lungs.
Antibiotics- These are given to fight against bacterial infections. There are certain chances of developing pneumonia.
Most f the babies show improvement in 2-4 months after the diagnosis of BPD. Once the lung function improves to where a baby can start breathing on their own, the breathing support and other medications can be terminated.
What Problems Can Occur Later?
Even after getting cured of BPD, some children later show issues, such as infections, pneumonia, flu, etc. If they catch such infections, they tend to get sicker more than other children do. BPD may also result in fluid buildup in the lungs, known as pulmonary edema. This causes difficulty in breathing. To prevent these, Diuretics are recommended.
Children present with BPD show slower growth than other children. They tend to lose weight easily by getting sick and may find it difficult to gain weight.
Conclusion
This article gives detailed information about chronic lung disease/Bronchopulmonary dysplasia, in which a child’s respiratory system is affected due to premature growth. This condition may get normal with time or requires treatment by providing oxygen support and other medications. Even after getting cured of BPD, they need extra care. Parents should make sure about all vaccinations, preventing them from infection as they are prone to it.
