Definitions and Diagnostic Criteria for Bronchopulmonary Dysplasia
Section snippets
Classic Versus New BPD
The severe form of BPD was mostly seen in infants who received aggressive ventilation, had a prolonged exposure to high inspired oxygen concentrations, and had characteristic changes in their chest radiographs, and hence, these factors were included in the diagnostic criteria for the original BPD. These infants had severe respiratory failure from the time of birth followed by severe lung injury due to the aggressive respiratory support, and they remained on ventilation and supplemental oxygen
Definition of BPD
There is a striking lack of uniformity in the diagnostic criteria for BPD among clinicians and in the literature. This explains, in part, the wide variation in the reported incidence of BPD among different centers. A major problem with the definition of BPD is that it is based primarily on the need for supplemental oxygen used as a marker of the pulmonary damage. Supplemental oxygen is an important part in the management of these infants, and in addition, it is implicated in the pathogenesis of
Physiologic Definition
To minimize the influence of different strategies for oxygen supplementation on the reported incidence of BPD,30 Walsh and collaborators have devised a physiologic test to standardize the need for oxygen at the time when BPD is being diagnosed.31 To accomplish this, infants with moderate dependency on oxygen at 36 w PMA (<30% oxygen) are challenged with room air breathing following a set weaning protocol to determine whether the supplemental oxygen is in fact needed. Although this test was
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2021, Journal of PediatricsCitation Excerpt :The primary outcome was a composite of chronic lung disease and/or death before discharge. Chronic lung disease was defined as the need for oxygen supplementation at 36 weeks corrected gestational age.11 The following secondary outcomes were recorded: pulmonary hemorrhage; surgical PDA ligation; culture positive sepsis; IVH status at 36 weeks corrected age; periventricular leukomalacia; NEC; retinopathy of prematurity requiring laser therapy; and days spent on invasive ventilation, continuous positive airway pressure, high-flow nasal cannula, and/or oxygen therapy.5,6,12
Oxygen Therapy in Children
2021, Encyclopedia of Respiratory Medicine, Second Edition