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Questions and Answers
What is the etiology of bronchopulmonary dysplasia (BPD)?
What is the etiology of bronchopulmonary dysplasia (BPD)?
- BPD is caused by a genetic mutation
- BPD is caused by oxygen toxicity alone
- BPD is caused by barotrauma from intubation and mechanical ventilation, oxygen toxicity, and infection (correct)
- BPD is caused by infection alone
What are the clinical manifestations of BPD?
What are the clinical manifestations of BPD?
- Dyspnea, tachypnea, airway hyperactivity, oxygen dependence, hypoxemia, hypercarbia, abnormal airway growth, tracheobronchomalacia, subglottic stenosis, increased pulmonary vascular resistance, pulmonary hypertension, cor pulmonale, and congestive heart failure (correct)
- Joint pain and swelling
- Headache, nausea, and vomiting
- Fever, cough, and chest pain
What is the severity index for BPD?
What is the severity index for BPD?
- Classifies BPD as mild, moderate, or severe based on oxygen therapy and/or positive-pressure ventilation requirements (correct)
- Classifies BPD as mild, moderate, severe, or critical based on oxygen therapy and/or positive-pressure ventilation requirements
- Classifies BPD as mild, moderate, or severe based on positive-pressure ventilation requirements only
- Classifies BPD as mild, moderate, or severe based on oxygen therapy requirements only
What is the recommended management for BPD?
What is the recommended management for BPD?
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What are the anesthetic considerations for a patient with BPD?
What are the anesthetic considerations for a patient with BPD?
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Study Notes
Etiology of BPD
- Premature birth and low birth weight are significant risk factors for developing bronchopulmonary dysplasia (BPD)
- Prolonged mechanical ventilation, oxygen toxicity, and inflammation contribute to the development of BPD
- Genetics, prenatal and perinatal infection, and growth restriction also play a role in the etiology of BPD
Clinical Manifestations of BPD
- Respiratory distress, tachypnea, and oxygen requirement are common presentations of BPD
- Chest radiographs may show hyperinflation, atelectasis, or interstitial markings
- Patients with BPD may exhibit failure to thrive, fatigue, and developmental delays
Severity Index for BPD
- The National Institutes of Health (NIH) severity index grades BPD as mild, moderate, or severe based on oxygen requirement at 36 weeks postmenstrual age (PMA)
- Mild BPD: breathing room air at 36 weeks PMA
- Moderate BPD: requiring <30% oxygen at 36 weeks PMA
- Severe BPD: requiring ≥30% oxygen at 36 weeks PMA or requiring mechanical ventilation
Management of BPD
- Primary goal is to manage respiratory symptoms and prevent further lung injury
- Oxygen therapy, mechanical ventilation, and surfactant administration may be necessary
- Medications such as bronchodilators, diuretics, and corticosteroids may be prescribed
- Nutrition support, immunizations, and developmental therapy are also important aspects of BPD management
Anesthetic Considerations for BPD
- Patients with BPD require careful preoperative assessment and optimization of respiratory status
- Anesthesia induction and maintenance should be tailored to minimize respiratory depression and avoid bronchospasm
- Postoperative pain management should prioritize non-opioid medications to reduce respiratory depression risk
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