Instead, there are usually uniformly dilated acini with thin alveolar septa and little or no interstitial fibrosis. It develops most commonly in the first 4 weeks after birth. Diagnosis
Earlier criteria
The classic diagnosis of BPD may be assigned at 28 days of life if the following criteria are met:
Positive pressure ventilation during the first 2 weeks of life for a minimum of 3 days. Clinical signs of abnormal respiratory function. Requirements for supplemental oxygen for longer than 28 days of age to maintain PaO2 above 50 mm Hg. Chest radiograph with diffuse abnormal findings characteristic of BPD.
This treatment increases the risk of neurodevelopmental sequelae (cerebral palsy) and gastrointestinal perforation.For babies 7 days old and older, "late systemic postnatal corticosteroid treatment" may reduce the risk of death and of bronchopulmonary dysplasia. There is some evidence that this treatment does not increase the risk of cerebral palsy, however, long-term studies considering the neurodevelopmental outcomes is needed to further understand the risk of this treatment option. Late systemic postnatal corticosteroid treatment is therefore only recommended for babies 7 days old or older who cannot be taken off of a ventilator. The benefit and risks of systemic corticosteroid treatment in older babies who are not intubated (on a ventilator) is not known. Vitamin A
Vitamin A treatment in low birth weight babies may improve the 36-week mortality risk, decrease the days of mechanical ventilation, and decrease the incidence of bronchopulmonary dysplasia. Other
Oxygen therapy at home is recommended in those with significant low oxygen levels.Hypercarbia (too much carbon dioxide in the blood) may contribute to the development of bronchopulmonary dysplasia. Monitoring the level of carbon dioxide in neonatal infants to ensure that the level is not too high or too low (hypocarbia) is important for improving outcomes for neonates in intensive care. Carbon dioxide can be monitored by taking a blood sample (arterial blood gas), through the breath (exhalation), and it can be measured continuously through the skin by using a minimally invasive transcutaneous device. The most effective and safest approach for measuring carbon dioxide in newborn infants is not clear.