Bronchopulmonary Dysplasia

Bronchopulmonary dysplasia (BPD) is chronic lung disease that develops primarily in very preterm infants whose lungs are still forming when respiratory support, oxygen exposure, inflammation, or infection causes additional injury. The infant may survive the original respiratory distress syndrome yet remain dependent on oxygen or positive-pressure support because gas exchange and pulmonary vascular growth are incomplete. For bedside decision-making, the trajectory matters more than a single oxygen reading. A stable infant with a low-flow requirement has a different risk profile from an infant needing CPAP or invasive ventilation at the same postmenstrual age. A new rise in support should prompt a search for an acute problem superimposed on BPD, such as infection, aspiration, airway obstruction, pneumothorax, pulmonary edema, or pulmonary hypertension.