Treating and Managing Bronchopulmonary Dysplasia

How Bronchopulmonary Dysplasia Is Treated

There is no specific cure for BPD, but treatment focuses on minimizing further lung damage and providing support for the infant’s lungs, allowing them to heal and grow. Newborns suffering from BPS are frequently treated in a hospital setting, where they can be continuously monitored. Types of drug therapies that may be used are:

• Diuretics: This class of drugs helps to decrease the amount of fluid in and around the alveoli. They are usually given by mouth one to four times per day.
• Bronchodilators: These medications help relax the muscles around the air passages, which makes breathing easier by widening the airway openings. They are usually given as an aerosol by a mask over the infant's face and using a nebulizer or an inhaler with a spacer.
• Corticosteroids: These drugs reduce and/or prevent inflammation within the lungs. They help reduce swelling in the windpipe and decrease the amount of mucus that is produced. Like bronchodilators, they are also usually given as an aerosol with a mask, either with the use of a nebulizer or an inhaler with a spacer.
• Viral immunization: Children with BPD are at increased risk for respiratory tract infections especially respiratory syncytial virus (RSV). Infants with moderate or severe BPD receive monthly injections with a medication that helps prevent the infection during the RSV season.
• Cardiac medications: A few infants with BPD may require special medications that help relax the muscles around the blood vessels in the lung, allowing the blood to pass more freely and reduce the strain on the heart.

Patients with more severe disease may need oxygen for several months. They may also need some form of support with a machine that delivers pressure through the nose through special prongs or a mask. These machines provide either nasal continuous positive airway pressure (NCPAP) or bilevel positive airway pressure (BiPAP). A small number of patients with very severe disease may need to stay on a ventilator for a long time, in which case they will need to receive a tracheostomy (a breathing tube inserted into the lungs through the neck).

Managing Bronchopulmonary Dysplasia

BPD tends to cause the most trouble during infancy and early childhood, with symptoms receding by 2 or 3 years of age and treatment ending by 5 years of age at the latest. However, the lungs may not develop normally and this can cause other lung problems later in life. This is why it is highly recommended that infants with BPD receive regular check-ups, timely vaccinations and consultations with a pediatric lung specialist at least during the first few years of life.

Premature infants with even mild BPD are at risk for other developmental problems. Many newborns with BPD will experience pauses in breathing (apnea), feeding complications that may be severe enough to require a feeding tube, GERD, pulmonary hypertension, neurologic complications, vision or hearing problems and various learning disabilities. Most of these complications are rare in those with mild to moderate BPD.

After discharge from the hospital, growth may still be delayed. Your child may continue to experience lung problems into adulthood. Many people who have BPD as infants may develop reactive airway disease or asthma and struggle with exercise intolerance for the rest of their life. They may also be more susceptible to infections, such as a cold or the flu. Symptoms of these viruses may be more severe, and it may take them longer to recover. Frequent hospitalizations are common, especially among those with moderate to severe BPD.

Finding Support

Caring for a premature infant struggling with bronchopulmonary dysplasia can be challenging. As a caregiver, it is important to take steps to limit the emotional stress put on your life. Your physicians can answer questions and assist with the newborn’s care, but you may also want to consider seeking support outside the hospital. Talk with your friends and family and consider joining a community support group for parents of premature newborns, such as our INSPIRE group. You can also call the Lung Association's Lung HelpLine at 1-800-LUNGUSA to talk to a trained respiratory professional who can help answer your questions and connect you with additional support.