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Bronchopulmonary Dysplasia

Bronchopulmonary dysplasia (BPD; formerly chronic lung disease of infancy) is a chronic lung disease in which premature infants, usually those who were treated with supplemental oxygen, require long-term oxygen. The alveoli that are present tend to not be mature enough to function normally. It is more common in infants with low birth weight (LBW) and those who receive prolonged mechanical ventilation to treat respiratory distress syndrome (RDS). It results in significant morbidity and mortality.  Bronchopulmonary dysplasia can be mild, moderate or severe. Many infants fully recover from this disorder. Others may have breathing difficulties during the first two years of life and even into the teen and adult years. Babies with this disorder are often in the hospital and need a lot of care. This breathing disorder is common in babies, born too early, since their lungs have not fully grown. In a recent study,1 we found that hypoxemia during OLV, defined by a decrease in arterial hemoglobin oxygen saturation (Sao2) to less than 90%, occurred in 4% of patients whose lungs were ventilated with a fraction of inspired oxygen (Fio2) greater than 0.5. Other studies2–5 using similar definitions of hypoxemia place the rate at 5–10%. Hypoxemia during OLV may affect the safety of the patient and is a challenge for the anesthesiologist and for the surgeon.

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