Premature babies and infants who are born with congenital respiratory conditions often need emergency oxygen therapy to survive. The constant flow of pure oxygen from a breathing machine, however, can actually disrupt lung development and lead to a condition called bronchopulmonary dysplasia. An infant with bronchopulmonary dysplasia has extreme difficulty breathing on his or her own and usually needs to remain on a mechanical ventilator for several days. Doctors focus treatment measures on controlling inflammation, preventing fluid buildup in the lungs, and ensuring that newborns receive enough nutrients. Infants who have the condition are at risk of having frequent respiratory problems throughout childhood.
The exact causes of bronchopulmonary dysplasia are unknown, but the fact that the majority of cases occur after infants are placed on ventilators lead doctors to believe that forced air damages developing lung tissue. The dilemma is that ventilation is the only way to prevent lung failure in babies whose lungs are underdeveloped or not functioning properly. Mechanical ventilators keep these babies alive, but the high concentration of oxygen and the continuous pressure of airflow seem to interrupt further lung development. It is also possible for a newborn to suffer from bronchopulmonary dysplasia without being on a ventilator if he or she experiences a severe lung infection shortly after birth.
Underdeveloped lungs that have been dependent on forced air cannot expand and contract sufficiently on their own. In addition, an infant's lungs that are used to the pure oxygen from machines have difficulty processing the much smaller concentration of oxygen in normal air. When a baby is not using a breathing machine, the physical symptoms of bronchopulmonary dysplasia become obvious. He or she may cough, wheeze, and breathe very rapidly. The skin and lips can begin to turn blue as a result of insufficient oxygen in the bloodstream.
When a baby suffers from breathing difficulties, specialists conduct a series of tests to confirm a diagnosis of bronchopulmonary dysplasia and rule out other conditions. Chest x-rays and computerized tomography scans reveal physical abnormalities, and blood tests are analyzed to check for low oxygen content and infection. Once a diagnosis has been made, the infant is given medications to treat inflammation and prevent fluid buildup. He or she is kept on a ventilator for several days, during which time the pressure and concentration of oxygen are gradually decreased.
The baby is weaned off of the ventilator while specialists carefully monitor lung development. The infant may still need to receive oxygen therapy after leaving the hospital, which is generally delivered through an oxygen hood or a continuous positive airway pressure (CPAP) device while the lungs continue to develop. Symptoms of bronchopulmonary dysplasia tend to go away around the age of two. A child may, however, experience respiratory infections and asthma attacks that require frequent doctor visits and daily medications.
