Abstract:
Bronchopulmonary Dysplasia (BPD) is a chronic neonatal lung disease characterized by impaired alveolar and vascular development and persistent respiratory dysfunction in preterm infants. Recent shifts from the historical, injury based definition toward a classification emphasizing arrested lung development have changed the diagnostic criteria and clinical management.
Methods: This poster presents a concise narrative reviewing current classification schemes for BPD and their implications for treatment, complications, and prognostic indicators. Sources include recent clinical guidelines and peer reviewed studies addressing pathophysiology, risk factors, diagnostic imaging, and therapeutic strategies.
Results:
- Epidemiology and risk factors: BPD primarily affects premature infants, with incidence strongly correlated with lower gestational age and birth weight. Risk factors are grouped as antenatal (e.g., chorioamnionitis), perinatal (e.g., delivery complications), and postnatal (e.g., prolonged mechanical ventilation, oxygen exposure). Pathophysiology and classification. The contemporary (“new”) BPD phenotype is dominated by disrupted alveolarization and inflammation, with elevated chemokines such as MCP 1 and MIP α implicated in alveolar injury. The classic phenotype reflects structural injury from prolonged oxygen therapy and positive pressure ventilation, leading to airway remodeling, surfactant dysfunction, fibrosis, and impaired gas exchange.
- Diagnosis and monitoring: Diagnosis relies on clinical history and radiological findings; classification incorporates oxygen/ventilatory support needs and imaging patterns.
- Therapeutic implications: Classification guides targeted interventions: minimizing ventilator induced lung injury and oxygen toxicity remain central for classic BPD, while anti inflammatory approaches (including corticosteroid use) and therapies that support lung growth are emphasized for the new phenotype. Supportive measures common to both include optimized respiratory support, exogenous surfactant when indicated, vitamin A supplementation, and careful use of inhaled nitric oxide in selected cases.
- Outcomes: Severity of BPD predicts long term respiratory morbidity and neurodevelopmental risk, with worse outcomes associated with lower birth weight and greater initial respiratory support.
Conclusion: Contemporary classification of BPD—distinguishing injury predominant from development arrest phenotypes—has practical consequences for diagnosis, individualized therapy, and prognostication. Recognizing phenotype specific mechanisms enables more targeted prevention and treatment strategies and may improve short and long term outcomes.
