In detail

Chronic lung disease in children (bronchopulmonary dysplasia)

Chronic lung disease in children (bronchopulmonary dysplasia)

Chronic lung disease in children, referred to medically as bronchopulmonary diplomacy, refers to the abnormalities of the lung tissue of newborns that cause a whole series of respiratory conditions. Most babies born with this condition manage to survive and lead a normal life by controlling the symptoms.

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Specifically, chronic lung disease (BPD) is a fibrosis (excessive tissue development) of the lungs, arising from several factors, such as inflammation of a viral infection or excessive use of oxygen. The symptoms of bronchopulmonary dysplasia appear very early, 3 days after birth, even during the hospitalization of the child in maternity.

Causes of chronic lung disease

Bronchopulmonary dysplasia or chronic lung disease has many causes, depending on the various factors that have contributed to the fetal lung damage, most commonly in the first 30 weeks of life.

Babies born before term are especially prone to BPD, because their insufficiently developed lungs are exposed to infections, inflammation and fluid filling. The most important triggers of the disease are:

  • premature birth, before 36 weeks (weighing less than 1 kg);
  • increased concentration of oxygen inspired by the extrauterine environment;
  • pressure and tensile forces applied to the airway by the fan after birth;
  • inflammation caused by various infections contacted by the newborn;
  • congenital malformations (persistence of the arterial canal) and other abnormalities that prevent the development of respiratory organs;
  • birth through Caesarean section (babies can have lungs full of fluid);
  • aspiration of meconium by the baby (fecal matter of the fetus, excreted in the first days of life);
  • insufficient vitamin A due to poor nutrition.

Symptoms of chronic lung disease

Even though the specific symptoms for chronic lung disease are often detected by maternity medical staff, there is a possibility that the first manifestations of the disease may occur at home after discharge. Bronchopulmonary dysplasia can be recognized by the following signs:

  • abnormal dilation of the nostrils;
  • accelerated breathing;
  • rib retraction due to excessive use of the neck, chest and abdominal respiratory muscles;
  • wheezing;
  • clear signs of exhaustion during feeding and after;
  • gray skin, especially on the face.

Common complications in children with BPD are respiratory infections caused by respiratory syncytial virus, airway obstruction (laryngotracheal stenosis) and airway blockage (traheomalacia).

The highest risk for children with pulmonary distress is intercurrent viral infections, which are responsible for the increase in mortality during the winter.

Diagnosis of chronic lung disease

The diagnosis for chronic lung disease is established by the neonatologist, according to the following specific criteria:

  • the child requires additional oxygen supply for 28 consecutive days after birth;
  • After 36 weeks of gestational age (the number of weeks since the beginning of pregnancy), the newborn needs a greater amount of oxygen than is normally found in the air.

Other diagnostic methods are blood tests, electrocardiogram and echocardiogram to monitor cardiac function and functional tests to assess the degree of lung damage.

Treatment of chronic lung disease

Bronchopulmonary dysplasia or chronic lung disease involves a treatment called "oxygen therapy" (direct inhalation of oxygen in the lungs), occasional use of mechanical ventilation, drug treatment (diuretics, bronchodilators and corticosteroids to reduce inflammation) and food supplementation (children who cannot heal). I normally receive milk through a nasogastric tube in my stomach, through my nose).

All of these interventions are designed to control the symptoms and help the baby breathe, while the lungs heal and mature properly. Although most children with this diagnosis recover in time, the manifestations of the diseases associated with BPD can be extended in the long term.

Do you personally know a case of BPD? Tell us about your experience in the comments section!