FIGURE 96.37 Bronchopulmonary dysplasia with hyperinflation This 2-month-old child was treated with mechanical ventilation during the first days of life for hyaline membrane disease The chest film shows generalized overaeration and coarse nodularity with multiple cystlike areas throughout both lung fields Prophylactic administration of Palivizumab decreases the number of admissions and acuity of RSV bronchiolitis in infants with BPD Palivizumab is administered monthly during RSV season Clinicians should ask parents about their child’s status Referral to the primary care provider for Palivizumab is warranted for any infant with BPD who was born less than 32 weeks and is within their first year of life Persistent Pulmonary Hypertension of the Newborn This entity is becoming increasingly recognized in the cyanotic neonate with respiratory distress It is more common in full-term infants in the hours to days after birth Hypoxia, meconium aspiration, congenital diaphragmatic hernia, and pulmonary hypoplasia are common causes immediately after birth; however, any condition that precipitates hypoxic respiratory failure may cause pulmonary hypertension later (e.g., acute viral infections) The constriction of the pulmonary arterial vasculature causes right-to-left shunting of deoxygenated blood through the patent DA or foramen ovale, resulting in hypoxia and severe cyanosis, which may improve with hyperventilation Infants may continue to have low oxygen saturations despite 100% inspired oxygen and aggressive mechanical ventilation