Learn About Bronchopulmonary Dysplasia
Bronchopulmonary dysplasia (BPD) is a form of chronic lung disease that affects newborns (mostly premature) and infants. In BPD the lung and the airways (bronchi) are damaged in the neonatal period, causing destruction (dysplasia) of the tiny air sacs of the lung (alveoli).
- BPD is associated with inflammation and scarring in the lungs
- BPD is much more common among low birth weight and premature infants.
- Most infants recover from BPD, but some may have long-term breathing difficulty.
- Infants are not born with BPD; the condition results from damage to the lungs caused by mechanical ventilation (respirator) and long-term use of oxygen.
- The severity of BPD is defined by the amount of oxygen an infant requires at time of birth and the length of use of supplemental oxygen or mechanical ventilation.
What Is Bronchopulmonary Dysplasia?
Prematurely born infants, especially those born before 28 weeks of gestation, have very few tiny air sacs (alveoli) at birth. The alveoli that are present tend to not be mature enough to function normal, and the infant requires respiratory support with oxygen or mechanical ventilation (a respirator) to support breathing. Although life-saving, these treatments can also cause lung damage, referred to as "broncho [airway] pulmonary [lung] dysplasia", or BPD.
How Bronchopulmonary Dysplasia Affects Your Body
BPD directly affects both the lungs and the rest of the body. In the lungs, a significant number of alveoli that become fibrotic (scarred) and stop working. This damage affects not only the existing alveoli, but also those that continuously develop after birth. The low number of working alveoli means that the affected infant will need to remain on a breathing machine (ventilator) and/or receive oxygen for an extended period of time. This oxygen can cause further damage.
The damage to the alveoli also causes damage to the blood vessels around them, making the passage of blood through the lungs more difficult. In the long run, this leads to increases in the pressure inside blood vessels in the lungs and between the heart and lungs (pulmonary hypertension) and puts significant strain on the heart, which in severe cases may lead to heart failure.
Because of the low number of working alveoli, the affected infant although needs to breathe much faster and harder than healthy infants. This work may slow early growth because the infants do not have the energy nor the time to feed properly, thus taking fewer calories in than they should, and burning most of the calories just to breathe. This leaves fewer calories for them to grow, with poor growth or "failure to thrive" that in turn may cause problems to other organs of the body.
How Serious Is Bronchopulmonary Dysplasia?
An estimated 10,000 newborns could develop BPD in the U.S. every year. Its severity varies from infant to infant. In mild cases, the infant may only have a faster than usual respiratory rate. In cases of moderate severity, the infant may require oxygen for several months. In uncommon but severe cases, the infant may have respiratory failure that requires not only oxygen but also prolonged need for mechanical ventilation.
This content was developed in partnership with the CHEST Foundation, the philanthropic arm of the American College of Chest Physicians.