Consumer Information

Bronchopulmonary Dysplasia

WHAT YOU SHOULD KNOW:

Bronchopulmonary (brong-ko-PUL-mo-nar-e) dysplasia (dis-PLA-zhah), 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 (swelling) 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. To help with this plan, you must learn about your baby's health condition and how it may be treated. You can then discuss treatment options with your baby's caregivers. Work with them to decide what care may be used to treat 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: You have the right to understand your child's health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your child's condition. Your child's caregiver should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives your child's caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to your child. Before giving your consent, make sure all your questions have been answered so that you understand what may happen to your child.

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 tiny tube placed in your child's vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.

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

Antibiotics: Antibiotics may be given to help your child fight an infection caused by a germ called 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, electrocardiogram, or telemetry. Three or five sticky pads are placed on your child's chest. Each pad has a wire leading to a TV-type screen or to a small portable box (telemetry unit). This screen or box shows a picture of your child's heartbeat. Caregivers watch this picture to make sure your child's heart is doing OK.
Pulse oximeter: A pulse oximeter is a machine that tells caregivers how much oxygen is 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. Tell a caregiver if the sticky strip or clip comes off of your child. The machine will alarm if the machine cannot read the oxygen level or if your child needs more oxygen. Tell a caregiver if the machine is alarming. Never turn the pulse oximeter off.
Vital signs: This includes taking your child's temperature, blood pressure, pulse (counting his heartbeat), and respirations (counting his breaths). To take your child's blood pressure, a cuff is put on his arm and tightened. The cuff is attached to a machine which gives your child's blood pressure reading. Caregivers may listen to your child's heart and lungs by using a stethoscope. Your child's vital signs are taken so caregivers can see how he is doing.

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 to help him breathe easier. Your child may need a nasal cannula (small tubes placed in the nose) or mask. Many children do not like having these on their face, so caregivers may place the mask next to your child's face. Some children are placed in an oxygen tent or plastic hood. Do not take off your child's oxygen without asking your child's 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 taken for tests. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV. Blood tests can give caregivers more information about your child's health condition. Your child may need to have blood drawn more than once.
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. Caregivers use it to see how your child's lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection (such as pneumonia) or other problems.
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.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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