Bronchopulmonary Dysplasia

WHAT YOU SHOULD KNOW:

• Bronchopulmonary dysplasia, or BPD, is a long-term condition that affects the lungs. BPD is also called chronic lung disease (CLD). This usually occurs in a premature baby who had lung problems shortly after birth and received treatment with high oxygen concentrations. A baby is premature if he is born earlier than 37 weeks gestation (time spent in womb). The lungs may have had an injury that causes inflammation and damage. These prevent the baby's lungs from working properly leading to serious breathing problems. The less the baby weighs and the more premature he is, the more likely he will have BPD.
  
  
• Signs and symptoms of BPD are cough, irritability, trouble breathing, and poor sucking or feeding. BPD may be diagnosed by having a chest x-ray, computerized tomography (CT) scan, echocardiogram, or blood tests. Treatment will depend on how bad your baby's BPD is. Your baby may need medicine or oxygen treatment to help him breathe easier. Most babies with BPD get better after a few weeks or months. With proper treatment and care, your baby is more likely to outgrow BPD without having further serious problems. Ask your caregiver for more information about these tests and treatment.

CARE AGREEMENT:

You have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's caregivers to decide what care you want for your baby.

RISKS:

Medicines for treating bronchopulmonary dysplasia may cause unwanted effects to your baby. He may be at risk of having decreased bone tissue, anemia (low blood count), or poor weight gain. He may also have high blood pressure or high blood sugar. Being hooked to a monitor or ventilator may make your baby uncomfortable. If left untreated, the breathing problems may cause low oxygen levels and affect your baby's heart and brain. He may be more likely to have infections or problems with his lungs, heart, or growth. Your baby may also have problems with his development, such as blindness, deafness, or learning problems. Ask your baby's caregiver if you have questions about your baby's condition, treatment, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

Feeding and nutrition:

It is important that your baby gets good nutrition. A caregiver, called a dietitian, may work with you to do this. Your baby may need to have extra calories. Ask caregivers if he can be breastfed. Your baby may also be fed through the following:

• Gastrostomy tube: This may also be called a feeding tube, "G-tube", or percutaneous endoscopic gastrostomy (PEG) tube. It is a soft tube that is put into your child's stomach during surgery. The tube comes out of your child's stomach through a small cut. This tube may be used to give your child liquids, food, and medicine. It may also be used to let air or fluids out of your child's stomach. Your child may have a gastrostomy tube for a short or long time.
  
  
• Nasogastric tube: This is also called an NG tube. An NG tube is inserted into your baby's nose and into his stomach. An NG tube will be used to feed your baby or to empty his stomach. Your baby may need this tube for feeding if your baby has problems eating through his mouth. Try not to let your baby pull on the NG tube. Tell a caregiver if the tube comes out of your baby's nose.
  
  
• Total parenteral nutrition: This is also called TPN. This provides your baby's body with nutrition such as protein, sugar, vitamins, minerals, and sometimes fat. TPN is usually put into your baby's body through an IV catheter.

IV:

An IV is a small tube placed in your child's vein. Caregivers use the IV to give your child medicine or liquids.

Medicines:

Caregivers may give your baby one or more of the following medicines:

• Antibiotics: This medicine is given to help prevent or treat an infection caused by bacteria.
  
  
• Blood pressure medicine: This medicine may be given to lower your baby's blood pressure. Keeping his blood pressure under control protects his heart, lungs, brain, kidneys, and other organs.
  
  
• Bronchodilators: Bronchodilators may be given to help open the air passages in your child's lungs to help him breathe easier.
  
  
• Diuretics: This medicine may be given to help your child's body and lungs get rid of extra fluid. This can help your child breathe easier. Diuretics may make your child urinate more often.
  
  
• Steroids: Steroid medicine may be given to help decrease inflammation in your baby's windpipe and lungs. This opens his air passages so he can breathe easier.

Monitoring:

Your baby may need to be watched using one or more of the following:

• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your child's skin record the electrical activity of his heart.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your child's blood. A cord with a clip or sticky strip is placed on your child's foot, toe, hand, finger, or earlobe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your child's oxygen level is low or cannot be read.
  
  
• Vital signs: Caregivers will check your child's blood pressure, heart rate, breathing rate, and temperature. They will also ask you or your child about his pain. These vital signs give caregivers information about your child's current health.

Respiratory care:

• Continuous positive airway pressure (CPAP): A CPAP machine is used to keep your baby's windpipe open during sleep. With CPAP your baby wears a mask over his nose. The mask is held in place by soft elastic straps that go around your baby's head. The mask is hooked up to the CPAP machine. The machine blows a gentle stream of air into the mask when your baby breathes. The stream of air helps keep his windpipe open so he can breathe more regularly. Extra oxygen may also be given through the machine.
  
  
• ET tube: Your child may need an endotracheal (ET) tube to help him breathe. An ET tube is put in your child's mouth or nose, and goes into the trachea (windpipe). It may be connected to a breathing machine called a ventilator. The ET tube will be taken out when your child is breathing better.
  
  
• Oxygen: Your child may need oxygen if his blood oxygen level is lower than it should be. Oxygen will help your child breathe easier. Your child may get oxygen through small tubes placed in his nostrils, or through a mask. He may instead be placed in an oxygen tent. Never take off your child's oxygen tubes or mask or remove him from the tent without asking his caregiver first.
  
  
• Suction: This is a small tube that is placed in your baby's mouth or nose. This tube will help suck out the liquid in your baby's mouth, nose, and lungs. This may help your baby breathe easier.

Tests:

• Blood gases: These tests are also called arterial blood gases (ABGs). Blood is taken from an artery usually in your child's wrist. ABGs may be done if your child has trouble breathing or other problems caused by his illness.
  
  
• Blood tests: Your child may need blood tests to give caregivers information about how his body is working. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV.
  
  
• Cardiac catheterization: A cardiac catheterization is a test to see how well your child's heart is working. It is also used to see how well the blood vessels connected to the heart are doing. A special tube is threaded into your child's heart through a blood vessel in his arm, leg, or neck. Dye may be given so x-ray pictures of your child's blood vessels show up better on a TV-like screen. Your child's caregiver may also measure the pressure inside your child's heart.
  
  
• Chest x-ray: This is a picture of your child's lungs and heart. A chest x-ray may be used to check your child's heart, lungs, and chest wall. It can help caregivers diagnose your child's symptoms, or suggest or monitor treatment for medical conditions.
  
  
• Computerized tomography scan: This test is also called a CT or CAT scan. A special x-ray machine uses a computer to take pictures of your baby's lungs. Before taking the pictures, he may be given a dye through an IV. The dye helps the lungs, heart, and blood vessels show up better in the pictures.
  
  
• Echocardiogram: This test is also called an echo. Sound waves are used to show pictures of the size and shape of your child's heart. The echo can also show how well the heart is pumping and how well blood flows through it. Your child will lie down during the test. Caregivers will squirt clear gel onto your child's chest to help the echo probe move easily. The echo pictures are shown on a TV-like screen. The whooshing noise that you may hear is the sound of blood flowing through the heart. Caregivers may ask you to stay in the room with your child during this test.
  
  
• Ventilation (V) and perfusion (Q) test: This test is also called a VQ or VP scan. A VQ scan is a two-part test which takes pictures of your baby's lungs to look for certain lung problems. During the perfusion part of the test, dye is put into your baby's blood vessels. The blood carries the dye to the blood vessels in your baby's lungs. Pictures are taken to see how blood flows in his lungs. During the ventilation part of the test, your baby will breathe in special gas. Pictures are taken to see how well his lungs take in oxygen.

Learn more about Bronchopulmonary Dysplasia (Inpatient Care)