FIGURE 99.2 Bronchopulmonary dysplasia 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 cyst-like areas throughout both lung fields Pulse oximetry is important to assess for hypoxemia ETCO2 measurement through noninvasive means or PCO2 measurement with arterial, venous, or capillary blood gas analysis is indicated when signs and symptoms predict hypercapnia or when cyanosis, respiratory distress, or deterioration from baseline cannot be easily reversed A CXR may provide additional information; however, given baseline abnormalities, these often need to be compared with prior films Bronchodilators, ICSs, and diuretics may also be helpful Most children with BPD have had trials of β-agonist therapy Although the use of MDIs for βagonists is effective in older infants with asthma, the evidence for their use in young infants with BPD is less well defined Although most acute episodes are from viral infection, antibiotic therapy should be considered when the risk of bacterial infection appears higher Prevention of BPD exacerbations is challenging Although routine viral illnesses may not be avoidable, RSV and influenza are the leading preventable causes of rehospitalization in patients with BPD Monoclonal antibody against RSV (palivizumab, Synagis) is used to help prevent or lessen disease secondary to RSV Such immunoprophylaxis is recommended for children less than year of age who: (i) were born prior to 29 weeks’ gestation, (ii) were born