FFinalistSouthampton · 2027
Child health
AKT · Child health/Neonatal & surgicallow yield

Bronchopulmonary dysplasia

Chronic lung disease of prematurity

Overview

Chronic lung disease of prematurity — oxygen dependence beyond 28 days of life (or 36 weeks corrected), from lung injury (ventilation, oxygen toxicity) on an immature lung.

Recognise

  • Prolonged oxygen requirement in an ex-preterm infant
  • Tachypnoea, recession, poor weight gain
  • Recurrent respiratory infections

Red flags

  • Pulmonary hypertension; severe RSV bronchiolitis

Differentials & how to tell them apart

Recurrent aspirationfeeding-related, reflux
Congenital heart diseaseecho
Bronchiolitisacute, viral

Investigations

Oxygen-dependence definition; CXR (hyperinflation, cystic changes); echo for pulmonary hypertension.

Management

Supplemental oxygen + RSV (palivizumab) prophylaxis where eligible

  1. 1Supportive: optimise oxygenation/nutrition; home oxygen if persistent need.
  2. 2Palivizumab prophylaxis against RSV for eligible infants; treat pulmonary hypertension.
Supplemental oxygen — home oxygen if needed
Palivizumab — RSV prophylaxis in eligible high-risk infants
Diuretics/inhaled steroids — selected cases

Key points

Eligible infants get palivizumab to prevent severe RSV bronchiolitis.

Monitor & prognosis

Growth, oxygen needs, pulmonary hypertension.

Lung function improves with growth; vulnerable to viral LRTIs.

Source: Neonatal/NICE guidance