A. Carlson Merrow, Jr., MD, FAAP; Randy R. Richardson, MD
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KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Bronchopulmonary dysplasia (BPD), chronic lung disease (CLD) of prematurity
Definitions
Old definition (1979): 28 days of oxygen (O₂) exposure + characteristic changes on radiographs
New NIH consensus definition (2001): Chronic disease of premature infants born at < 32 weeks gestation with O₂ dependency for at least 28 days
Assessed at 36 weeks postmenstrual age (PMA)
Chest radiograph abnormalities no longer required
Physiologic modification (2004): Specific O₂ challenge at 36 weeks PMA; has lead to more standardized diagnosis
Failure to maintain O₂ saturation > 90% during trial of 21% inspired O₂
Clinically validated
Predicts cognitive impairment
Classic or old BPD of early descriptions: Larger, later preterm infants with prolonged mechanical ventilation & O₂ therapy leading to inflammation & fibrosis
New BPD: More diffuse but overall milder disease of earlier, smaller preterm infants in setting of antenatal steroids, postnatal surfactant administration, & reduced ventilator/O₂ intensity yielding less inflammation & fibrosis
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
Dassios T et al: Correlation of radiographic thoracic area and oxygenation impairment in bronchopulmonary dysplasia. Respir Physiol Neurobiol. 220:40-5, 2016
Sehgal A et al: Right ventricular function in infants with bronchopulmonary dysplasia: association with respiratory sequelae. Neonatology. 109(4):289-296, 2016
Keszler M et al: Mechanical ventilation and bronchopulmonary dysplasia. Clin Perinatol. 42(4):781-96, 2015
Mourani PM et al: Pulmonary hypertension and vascular abnormalities in bronchopulmonary dysplasia. Clin Perinatol. 42(4):839-55, 2015
Walkup LL et al: Quantitative magnetic resonance imaging of bronchopulmonary dysplasia in the neonatal intensive care unit environment. Am J Respir Crit Care Med. 192(10):1215-22, 2015
Walkup LL et al: Newer imaging techniques for bronchopulmonary dysplasia. Clin Perinatol. 42(4):871-87, 2015
Baker CD et al: Pulmonary hypertension in preterm infants with bronchopulmonary dysplasia. Pediatr Allergy Immunol Pulmonol. 27(1):8-16, 2014
El Mazloum D et al: Chronic lung disease of prematurity: long-term respiratory outcome. Neonatology. 105(4):352-6, 2014
Jensen EA et al: Epidemiology of bronchopulmonary dysplasia. Birth Defects Res A Clin Mol Teratol. 100(3):145-57, 2014
Liu J et al: BPD, Not BPD, or iatrogenic BPD: findings of lung ultrasound examinations. Medicine (Baltimore). 93(23):e133, 2014
Bhandari A et al: Long-term pulmonary outcomes of patients with bronchopulmonary dysplasia. Semin Perinatol. 37(2):132-7, 2013
Carraro S et al: Bronchopulmonary dysplasia: the earliest and perhaps the longest lasting obstructive lung disease in humans. Early Hum Dev. 89 Suppl 3:S3-5, 2013
Kjellberg M et al: Bronchopulmonary dysplasia: clinical grading in relation to ventilation/perfusion mismatch measured by single photon emission computed tomography. Pediatr Pulmonol. 48(12):1206-13, 2013
Kair LR et al: Bronchopulmonary dysplasia. Pediatr Rev. 33(6):255-63; quiz 263-4, 2012
Parad RB: Update on the diagnosis and management of bronchopulmonary dysplasia/chronic lung disease of infancy: what the radiologist should know. Pediatr Radiol. 42 Suppl 1:S92-100, 2012
Wilson AC: What does imaging the chest tell us about bronchopulmonary dysplasia? Paediatr Respir Rev. 11(3):158-61, 2010
Aukland SM et al: Neonatal bronchopulmonary dysplasia predicts abnormal pulmonary HRCT scans in long-term survivors of extreme preterm birth. Thorax. 64(5):405-10, 2009
Bhandari A et al: Pitfalls, problems, and progress in bronchopulmonary dysplasia. Pediatrics. 123(6):1562-73, 2009
Oppenheim C et al: Bronchopulmonary dysplasia: value of CT in identifying pulmonary sequelae. AJR Am J Roentgenol. 163(1):169-72, 1994
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Bronchopulmonary dysplasia (BPD), chronic lung disease (CLD) of prematurity
Definitions
Old definition (1979): 28 days of oxygen (O₂) exposure + characteristic changes on radiographs
New NIH consensus definition (2001): Chronic disease of premature infants born at < 32 weeks gestation with O₂ dependency for at least 28 days
Assessed at 36 weeks postmenstrual age (PMA)
Chest radiograph abnormalities no longer required
Physiologic modification (2004): Specific O₂ challenge at 36 weeks PMA; has lead to more standardized diagnosis
Failure to maintain O₂ saturation > 90% during trial of 21% inspired O₂
Clinically validated
Predicts cognitive impairment
Classic or old BPD of early descriptions: Larger, later preterm infants with prolonged mechanical ventilation & O₂ therapy leading to inflammation & fibrosis
New BPD: More diffuse but overall milder disease of earlier, smaller preterm infants in setting of antenatal steroids, postnatal surfactant administration, & reduced ventilator/O₂ intensity yielding less inflammation & fibrosis
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
Dassios T et al: Correlation of radiographic thoracic area and oxygenation impairment in bronchopulmonary dysplasia. Respir Physiol Neurobiol. 220:40-5, 2016
Sehgal A et al: Right ventricular function in infants with bronchopulmonary dysplasia: association with respiratory sequelae. Neonatology. 109(4):289-296, 2016
Keszler M et al: Mechanical ventilation and bronchopulmonary dysplasia. Clin Perinatol. 42(4):781-96, 2015
Mourani PM et al: Pulmonary hypertension and vascular abnormalities in bronchopulmonary dysplasia. Clin Perinatol. 42(4):839-55, 2015
Walkup LL et al: Quantitative magnetic resonance imaging of bronchopulmonary dysplasia in the neonatal intensive care unit environment. Am J Respir Crit Care Med. 192(10):1215-22, 2015
Walkup LL et al: Newer imaging techniques for bronchopulmonary dysplasia. Clin Perinatol. 42(4):871-87, 2015
Baker CD et al: Pulmonary hypertension in preterm infants with bronchopulmonary dysplasia. Pediatr Allergy Immunol Pulmonol. 27(1):8-16, 2014
El Mazloum D et al: Chronic lung disease of prematurity: long-term respiratory outcome. Neonatology. 105(4):352-6, 2014
Jensen EA et al: Epidemiology of bronchopulmonary dysplasia. Birth Defects Res A Clin Mol Teratol. 100(3):145-57, 2014
Liu J et al: BPD, Not BPD, or iatrogenic BPD: findings of lung ultrasound examinations. Medicine (Baltimore). 93(23):e133, 2014
Bhandari A et al: Long-term pulmonary outcomes of patients with bronchopulmonary dysplasia. Semin Perinatol. 37(2):132-7, 2013
Carraro S et al: Bronchopulmonary dysplasia: the earliest and perhaps the longest lasting obstructive lung disease in humans. Early Hum Dev. 89 Suppl 3:S3-5, 2013
Kjellberg M et al: Bronchopulmonary dysplasia: clinical grading in relation to ventilation/perfusion mismatch measured by single photon emission computed tomography. Pediatr Pulmonol. 48(12):1206-13, 2013
Kair LR et al: Bronchopulmonary dysplasia. Pediatr Rev. 33(6):255-63; quiz 263-4, 2012
Parad RB: Update on the diagnosis and management of bronchopulmonary dysplasia/chronic lung disease of infancy: what the radiologist should know. Pediatr Radiol. 42 Suppl 1:S92-100, 2012
Wilson AC: What does imaging the chest tell us about bronchopulmonary dysplasia? Paediatr Respir Rev. 11(3):158-61, 2010
Aukland SM et al: Neonatal bronchopulmonary dysplasia predicts abnormal pulmonary HRCT scans in long-term survivors of extreme preterm birth. Thorax. 64(5):405-10, 2009
Bhandari A et al: Pitfalls, problems, and progress in bronchopulmonary dysplasia. Pediatrics. 123(6):1562-73, 2009
Oppenheim C et al: Bronchopulmonary dysplasia: value of CT in identifying pulmonary sequelae. AJR Am J Roentgenol. 163(1):169-72, 1994
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