Wednesday, May 4, 2011

Bronchopulmonary Dysplasia (BPD) / Chronic Lung Disease

I remember the first time I heard “your son has severe bronchopulmonary Dysplasia (BPD)". Time seemed to stop for a moment...

Of course I listened to what the doctors had to say, but it seemed like every time they talked I didn't quite hear WHAT they were saying...not sure why that happens.

Soon, thereafter, I did my own research (its just easier to read it sometimes than actually hear it).
So, in laymans terms here is what I have learned about BPD from my experience with it.

Bronchopulmonary Dysplasia is also known as Chronic Lung disease and it affects babies.

It is one of the most common chronic lung diseases in children and it can range from mild to severe (as in my son’s case).

BPD can start with Respiratory Distress Syndrome (RDS) and RDS occurs in babies whose lungs have not developed completely. It is mainly caused by a lack of a substance called surfactant (a natural lubricant that improves lung function).

Symptoms:
  • Blue Color of Skin (Cyanosis)
  • Apnea (a brief stop in breathing)
  • Nasal flaring
  • Rapid, shallow breathing
  • Shortness of breath and grunting sounds
  • Retractions (pulling at rib cage) while breathing
If symptoms of RDS continue after a about month or so, then the condition will be considered to be BPD.
BPD is defined by inflammation and scarring in the lungs, most commonly found in premature and low birth weight infants.

It can also be caused by other conditions other than premature birth such as pneumonia's or RSV (respiratory syncytial virus). So, BPD can even happen in a healthy full-term baby and sometimes (but rare) in older children.

White (Caucasian), boy babies seem to be at greater risk for developing Bronchopulmonary Dysplasia, for reasons that are unknown, and most babies will outgrow the more severe symptoms of BPD.


How is BPD Diagnosed and Treated?

In my son’s case he was; premature, had RDS, became septic (infection), exposed to high oxygen, and of course he was ventilator dependent (so, he required a tracheostomy). His Chest X-ray’s and CT scans showed scarring of lung tissue. All indicating factors of Bronchopulmonary Dysplasia.

There is no cure BPD. Just time. Babies diagnosed receive intensive support in the hospital, until they are stable enough to be transferred to a rehab hospital or (as in our case) home.


Medications

If the baby is born and has RDS, doctors may be give, a dose of surfactant (in my sons case two doses), this may decrease the chance for BPD to develop.

The medications used to treat my son's BPD were; Albuterol,a bronchodilator, (helps keep small airway sacs open). Lasix (furosemide), a diuretic that helps decrease fluid build up in the lungs. Flovent, (an inhaled steroid). He remains on this even today for maintenance of his asthma. He was also on course of prednisolone (a strong anti-inflammatory) for an extended period of time,, spironolactone (a.k.a., Aldactone),which also removes excess fluid from body, and a K supplement(potassium).
BPD babies are also at high risk of developing infections so antibiotics are sometimes needed.


Nutrition

Nutrition is also extremely important. BPD babies may need high-calorie formulas through a nasal gastric tube (NG tube) or a gastrointestinal tube (G-tube), which is surgically placed.

Why an NG tube or G-tube? BPD babies have a difficult time eating by mouth, they tend to burn alot of calories just trying to breath, when they eat they burn even more calories, resulting in poor weight gain. The tubes are a way to get the calories into the baby without effort on the babies part.

Result? More growth. Which means? More new and healthy lung tissue.

New lung tissue that forms may ultimately take over much of the work of breathing for diseased lung tissue. Babies continue to grow new lung tissue for 5-7 years.

Babies with BPD are slow to improve(mine sure was). After coming through the more severe stages of BPD, some may have longer-term complications (my son has asthma).

How to care for your Child who has BPD once s/he comes home?

We, as parents have a critical role in the care of our children when they leave the hospital.

One essential safety measure for us was to reduce Collin’s exposure to infections.

I limited visits from people who were sick, even eliminated them. When he got a little stronger I limited play dates to 1-2 children and also delayed him from starting school for a year. (some may tell you I was a little over the top, but I don’t think so!)

Also, it is very important that babies receive all the recommended vaccinations to prevent further illness.
Continue the high-calorie formula if you were asked to do so. Children with BPD sometimes can grow slower and are slower gain weight due to breathing problems.

Try to remember, each case of Broncopulmonary Dysplasia is different and every child is different.
Thankfully, new studies are always being done and new treatments become available.


So, as always please consult with your NICU team for further information on the treatments available for Bronchopulmonary Dysplasia.

For more information on  how infant massage reduces stress in preemies check out this article: click here.

2 comments:

  1. Hi,
    Generally we do not have any type of information and we do not know about some disease but noe a days there are lots of information provide on internet. I read this your details about chronic lung disease and i am aware about this disease. Hope all are know about Chronic Lung Disease.

    Thank you so much to share this important information with me.
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    Asthmatic Bronchitis Symptoms

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