Bronchopulmonary Dysplasia Clinical Presentation

Updated: Jan 13, 2020
  • Author: Namasivayam Ambalavanan, MD, MBBS; Chief Editor: Muhammad Aslam, MD  more...
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Presentation

History and Physical Examination

History

There is usually a history of very preterm birth, frequently associated with chorioamnionitis, preterm labor, preterm rupture of membranes, or a need for iatrogenic delivery (due to maternal preeclampsia or other complications). Infants who develop bronchopulmonary dysplasia (BPD) often have a history of persistent need for a high level of respiratory support from birth, often with need for mechanical ventilation or CPAP from soon after birth.

Physical examination

Infants with BPD have abnormal findings on physical examination, chest radiography, pulmonary function testing, and histopathologic examination. Initial findings observed shortly after birth are consistent with respiratory distress syndrome (RDS). Persistence of these abnormalities can be associated with an increased risk of bronchopulmonary dysplasia.

Physical examination may reveal tachypnea, tachycardia, increased work of breathing (with retractions, nasal flaring, and grunting), frequent desaturations, and significant weight loss during the first 10 days of life.

Infants with severe bronchopulmonary dysplasia are often extremely immature and had a very low birth weight. Their requirements for oxygen and ventilatory support often increase in the first 2 weeks of life. At weeks 2-4, oxygen supplementation, ventilator support, or both are often increased to maintain adequate ventilation and oxygenation.