pediatrics
Bronchopulmonary Dysplasia (BPD)
Etiology of Bronchopulmonary Dysplasia
BPD has a multifactorial etiology. Significant risk factorsinclude Prolonged Mechanical Ventilation None High concentrations of inspired oxygen Infection (eg, Intraamniotic Infection or Preterm Infants None Additional risk factorsinclude Pulmonary interstitial emphysema High peak inspiratory pressures Large end-tidal volumes Repeated alveolar collapse Increased airway resistance Increased pulmonary artery pressures Male sex Intrauterine growth restriction Genetic susceptibility Maternal smoking The lungs of preterm infants are more vulnerable to the inflammatory changes that result from mechanical ventilation. The development of normal lung architecture is interrupted; fewer and larger alveoli develop, and the interstitium is thickened. Also, the pulmonary vasculature develops abnormally, with fewer and/or abnormally distributed alveolar capillaries; pulmonary resistance may be increased and Persistent Pulmonary Hypertension of the Newborn can develop ( 1.Kalikkot Thekkeveedu R, Guaman MC, Shivanna B: Bronchopulmonary dysplasia: A review of pathogenesis and pathophysiology.Respir Med132:170–177, 2017. doi: 10.1016/j.rmed.2017.10.014 