Bronchopulmonary dysplasia
Background
- Chronic lung disease that develops in premature infants who require prolonged mechanical ventilation and/or supplementary oxygen, usually due to respiratory distress syndrome
- Develops within first 4 weeks of life while infant still in NICU
- Typically lung function improves with time, but many require long term O2 supplementation or other therapy
Clinical Features
- May be asymptomatic until something (e.g. infection, respiratory irritant) triggers decompensation
- SOB
- Hypoxia
- Increased respiratory secretions
- Wheezing, crackles
- +/- pulmonary hypertension
- Poor feeding
Differential Diagnosis
Pediatric Wheezing
- Upper Airway diseases
- Large Airway Obstruction
- Foreign body aspiration
- Vascular ring or laryngeal webs
- Laryngotracheomalacia
- Enlarged lymph node or tumor
- Vocal cord dysfunction
- Small Airway Obstruction
- Asthma
- Viral bronchiolitis
- Cystic Fibrosis
- Bronchopulmonary dysplasia
- Congenital heart disease or other cardiac disease
- Other causes
Evaluation
- Typically not an ED diagnosis
- Evaluate for precipitants of decompensation (e.g. infectious workup etc.)
- CXR
- Hyperinflation, low diaphragm, atelectasis, cystic changes
Management
- Escalate chronic home therapies
- Supplementary O2 and/or positive pressure ventilation as needed
- Bronchodilators
- Diuretics if euvolemic-hypervolemic
- Treat decompensated pulmonary hypertension
Disposition
- Low threshold to admit for acute respiratory symptoms
See Also
External Links
References
This article is issued from
Wikem.
The text is licensed under Creative
Commons - Attribution - Sharealike.
Additional terms may apply for the media files.