BPD - Clinical
Introduction Pathogenesis Clinical Prevention Management Prognosis References Abbreviations Other Lectures		Two distinct clinical presentations are described for babies with BPD, classic and atypical. Xray changes in atypical BPD consist of a persistent diffuse haziness, without the cysts, emphysema and atelectasis characteristic of classic BPD. Once BPD is established, regardless of the initial clinical presentation, there is a chronic respiratory insufficiency and prolonged oxygen dependency. Physical exam features include tachypnea, retractions, inspiratory crackles and expiratory wheezing. There are consistent pulmonary function abnormalities, including V/Q mismatch and increased physiologic dead space which, in turn, lead to hypoxia and CO2 retention. There are often clinical exacerbations, characterized by cyanosis, wheezing, increased distress and oxygen requirement, associated with episodes of pulmonary edema or pneumonia. The latter is often difficult to diagnose on the already quite abnormal xray, leading to many courses of antibiotics for clinically suspected pneumonia. Babies with established BPD are at increased risk of sepsis, PDA, IVH, ROP and death.