DOI: 10.36347/sjams.2018.v06i11.081

Pages: 4612-4616

Bronchopulmonary dysplasia is defined as oxygen dependency at 28 days of age or 36 weeks postmenstrual age. Pathophysiology of BPD is characterized by cytokine dysregulation, pulmonary edema, increased alveolar & capillary permeability, arrest in lung development & pulmonary interstitial thickening. Pathology in old BPD consists of alternating areas of atelectasis & overinflation, severe airway epithelial lesions, airway smooth muscle hyperplasia, extensive fibroproliferation, pulmonary hypertension & decreased internal surface area of alveoli. New BPD consists of fewer & larger simplified alveoli, negligible airway lesions, variable airway smooth muscle hyperplasia, variable interstitial fibroproliferation, fewer & dysmorphic capillaries & less severe arterial lesions. Risk factors for development of BPD include Prematurity, Mechanical ventilation with subsequent barotrauma / volutrauma, Oxygen toxicity, Genetic polymorphisms, Patent ductus arteriosus, fluid overload, Poor nutrition, Infection & inflammation & Surfactant deficiency. Abnormal vasculogenesis, hyperoxia, oxidant injury, nutritional imbalance, extracellular matrix alterations, nitric oxide, altered immune system, genetic factors, mechanical ventilation induced lung injury, PDA & fluid overload are some of the factors favouring occurrence of BPD. Management of BPD consists of judicious use of oxygen, steroids, caffeine, diuretics, gentle ventilation & antioxidant therapies.