Broncho Pulmonary Dysplasia. The following discussion will analyse issues related to babies who develop broncho pulmonary dysplasia (BPD). This will include a definition and identify risk factors, treatment and the eventual outcome of babies admitted to

Authors Avatar
University Degree Subjects allied to Medicine

The following discussion will analyse issues related to babies who develop broncho pulmonary dysplasia (BPD). This will include a definition and identify risk factors, treatment and the eventual outcome of babies admitted to the neonatal intensive care unit (NICU). An overview of the difficult stages that a baby with BPD goes through before being ready for discharge will be discussed to show that these babies and their families need special attention when it comes to planning their discharge.

        Northway et al first described BPD in 1967 as lung injury, in preterm infants resulting from the need for oxygen and mechanical ventilation. Even though it was the first definition, the most commonly used is that of Bancalari et al( 1979) who explained that BPD usually occurred following 28 days of oxygen therapy with evidence radiographic changes. Brodwich and Mellins (1985) found that the combination of oxidant injury and mechanical ventilation resulted in inflammation, fibrosis and smooth muscle hypertrophy in the airways. Also that BPD is the most common complication of preterm babies weighing <1kg.

 Cunha (2005) carried out a prospective cohort study using 86 newborns  with a birth weight <1500 g, who received mechanical ventilation during their first week of life and survived 28 days. The findings demonstrated that the most important risk factors for BPD were prematurity, patent ductus arteriosus (PDA), elevated levels of PIP and fluid volume. Oxygen toxicity, mechanical lung trauma, infections or pneumonia added to the risk of developing BPD. In contrast Mantkelow et al (2001) found that the administration of antenatal corticosteroids to the mother, the use of early surfactant therapy and also gentle modalities to the ventilation for the babies at birth minimised the incidence of BPD.  However, even with the evidence that giving antenatal dexamethazone to the mother reduces the number of days of ventilator support  (Knoppert and Mackengee (1994), Davies and Henderson-Smart (1998), some doctors are reluctant to prescribe it, due to the associated side effects such as neuromotor dysfunction, poor growth, cerebral palsy (Yeh et al1998, Crawford and Hickenson 2002, E. Banclari 2005).

 In practice there have been recent advances in weaning techniques from mechanical ventilation including the use of assisted CPAP and low flow oxygen. The new system used provides nasal CPAP with the addition of pressure support. This can be delivered as determined by the medical staff, or can be set to trigger and synchronise with the babies own respiratory effort by the use of an apnoea/respiratory monitor. The aim is to avoid re-intubations (Barrington et al 2001). Possible problems have been identified with early extubation which include:  feeding complications due to the increased work of breathing and reduced optimal growth due to increased energy output (Swanson and Naber 1997).

Furthermore, low flow oxygen via nasal prongs is used to administer the supplemental oxygen which a baby with BPD requires when either discontinued CPAP or transferred from an incubator to a cot. Once a baby stabilises on nasal low flow oxygen, they are moved eventually from the intensive care unit to high dependency and then to a special care nursery. The primary objectives include establishing feeds and trying to wean the baby to the lowest most acceptable amounts of oxygen to maintain good oxygen saturation. Yeo (2002) suggests that these babies often suffer from gastro-oesophageal reflux and regularly need supplements such as Gaviscon to thicken feeds to avoid reflux and associated aspiration.

Join now!

It is very clear that neonatal nurses are in a prime position to provide support to parents when they are in the NICU (Turril1999; Crathern 2009). They have a prime role in alleviating the fears of the environment and to adjust to the need of the family (Boxwell 2010). It has been observed that babies with BPD can be very irritable and demanding as they grow and they require a lot of patience from their carers. Increasing parents’ awareness about why their baby’s breathing is such hard work with BPD can benefit them when dealing with the stress involved in ...

This is a preview of the whole essay

Broncho Pulmonary Dysplasia. The following discussion will analyse issues related to babies who develop broncho pulmonary dysplasia (BPD). This will include a definition and identify risk factors, treatment and the eventual outcome of babies admitted to
Document Details
  • Word Count
    2745
  • Page Count
    11
  • Level
    University Degree
  • Subject
    Subjects allied to Medicine
Related Essays
Chronic obstructive pulmonary disease (COPD)
Chronic obstructive pulmonary disease (COPD)
To identify and focus on a specific risk to a patient. In order to do this effectively, a recognised risk assessment tool will be used and a treatment plan
To identify and focus on a specific risk to a patient. In order to do this...
HIGH DEPENDENCY CARE OF THE NEW BORN. The following discussion will analyse the care of a baby who I have recently looked after in the high dependency who developed necrotising entero colitis(NEC) and consequently had to be re admitted to the NICU.
HIGH DEPENDENCY CARE OF THE NEW BORN. The following discussion will analys...
The purpose of this essay will be to analyse and evaluate the nursing care given to an individual during their stay at a respiratory ward whilst using the nursing process as its foundation
The purpose of this essay will be to analyse and evaluate the nursing care...