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HS8116: Case Study 1b: Our Group Members Are: Zhao Xinmei Khong Huilin
HS8116: Case Study 1b: Our Group Members Are: Zhao Xinmei Khong Huilin
Bronchopulmonary Dysplasia
(BPD)
Definition of Bronchopulmonary
dysplasia
• Also known as chronic lung disease (CLD)
• Dysplasia: abnormal development
• An infant who are oxygen dependent at 1
month of age or 36 weeks postmenstrual
age, and associated with an abnormal chest
radiograph appearance
(Genen & Davis, 2007).
Diagnostic Criteria for
Bronchopulmonary Dysplasia
Gestational age
Time point of 36 weeks PMA or discharge to home, whichever comes first >28 days but <56 days postnatal age or discharge to home,
assessment whichever comes first
Mild BPD Breathing room air at 36 weeks PMA or discharge, whichever Breathing room air by 56 days postnatal age or discharge, whichever
comes first comes first
Moderate BPD Need* for <30 percent oxygen at 36 weeks PMA or discharge, Need* for <30 percent oxygen at 56 days postnatal age or discharge,
whichever comes first whichever comes first
Severe BPD Need* for ≥30 percent oxygen and/or positive pressure (PPV or
NCPAP) at 36 weeks PMA or discharge, whichever comes first Need* for ≥ 30 percent oxygen and/or positive pressure (PPV or
NCPAP) at 56 days postnatal age or discharge, whichever comes
first
NCPAP: nasal continuous positive airway pressure; PMA: postmenstrual age; PPV: positive-pressure ventilation.
Oxygen therapy
• pH 7.25-7.40
• pCO2 45-65 mmHg
• pO2 50-70 mmHg
• Oxygen saturation at 88-94%
Fluid Management
• Infants with BPD tolerate excessive or even
normal amounts of fluid intake poorly
• Tendency to accumulate excessive interstitial
fluid in the lung which causes pulmonary
edema and congestive heart failure
• Water and salt must be limited to minimum
required
• Diuretics therapy
Medications
• Diuretics
• Bronchodilators
• Corticosteroids
• Vasodilators
Diuretics
Furosemide (loop diuretics)
• Improves clinical pulmonary status and function
• Decrease pulmonary vascular resistance
• Facilitate weaning from positive pressure
ventilators and oxygenation
• Strict handwashing
• Strict adherence to sterile technique in assessing
line and invasive procedures
• Periodic collection of tracheal secretions for c/s,
obtain FBC, bld c/s, and chest x-ray if pneumonia
suspected
Nursing management
Mechanical ventilation
• Martin, R.J., Fanaroff, A.A. and Walsh, M.C. (2006). Fanaroff and
Marti’s Neonatal-Perinatal Medicine: Disease of the Fetus and
Infant. (8th ed.). Philadelphia: Mosby Elsevier.