Bronchopulmonary dysplasia

        Bronchopulmonary dysplasia (BPD) is a common complication in newborn who require ventilatory therapy. The cumulative effects of oxygen exposure and the trauma of positive pressure ventilation in the immature lung are thought to be the primary causes [1]. Patients with BPD are cyanotic and oxygen-dependent, and have respiratory distress [2]. The clinical diagnosis of BPD is based on the facts that after 28 days of life there is a continuing need for oxygen and chest radiographic abnormalities persist [1].  An orderly progression of BPD through the four stages as first described by Northway and Rosan is uncommon [2,3]. Currently the severe cystic form of BPD is quite unusual and seen mostly in infants born very prematurely. Complications of BPD include tracheomalacia, tracheal stenosis, long-standing atelectasis, and acquired lobar emphysema [1].
        The findings of BPD on chest films vary, depending on the degree of focal overaeration of the alveoli, the degree of associated interstitial inflammatory change, and fibrosis [4,5]. These lead to overaeration of the lungs, diffuse haziness of the lungs, irregular infiltrates, streaks, or bubbles.

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bpd
.Figure 1. Note atelectasis of right upper lobe, haziness in the left
lung, bubbles in the right lower lobe, and a metallic clip from
previous surgical closure of a patent ductus arteriosus.
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..bpd-emphysema.
Figure 2. Note overaeration, haziness of the left lung, and
acquired lobar emphysema of the right upper lobe.
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REFERENCES
1. Newman B. Imaging of medical diseases of the newborn lung. Radiol Clin North Am 1999;37:1049-65.
2. Mandell GA. Imaging evaluation of the neonate. In: Goodman LR, Putman CE, editors. Critical care imaging. 3rd ed. Philadelphia: W.B. Saunders, 1992: 420-3.
3. Hedlund GL, Griscom NT, Cleveland RH, Kirks DR. Respiratory system. In: Kirks DR, editor. Practical pediatric imaging: diagnostic radiology of infants and children. 3rd ed. Philadelphia: Lippincott-Raven, 1998:708-710.
4. Leonidas JC, Berdon W. Neonatal chest. In: Silverman FN, Kuhn JP, editors. Caffey's pediatric x-ray diagnosis: an integrated imaging approach. 9th ed. St. Louis: Mosby, 1993:1984-93.
5. Swischuk LE. Respiratory system. In: Imaging of the newborn, infant, and young child. Baltimore: Williams & Wilkins, 1997: 47-9.
 
 

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