Cincinnati Children’s Hospital Medical Center Establishes Bronchopulmonary Dysplasia Center for the Most Fragile Babies

Tuesday, January 22, 2019

Cincinnati Children’s has established a Bronchopulmonary Dysplasia (BPD) Center that provides advanced imaging and a team approach to care for the most fragile babies with abnormalities of the lung, heart and airway due to premature birth.

BPD is a common and chronic lung disease, particularly in infants born more than two months early and who need respiratory support for long periods of time. Most babies with BPD are diagnosed within the first four weeks of birth and improve gradually over time. Some recover lung function that is close to normal, while others have long-term lung damage that requires significant medical care over the course of a lifetime.

The National Institutes of Health estimates that 10,000-15,000 babies born in the United States develop BPD each year.

“Our team is multidisciplinary, which means that we work together to treat all the components of BPD and collaborate with experts throughout Cincinnati Children’s to provide customized treatment for a baby’s individual needs,” says Paul Kingma, MD, PhD, neonatal director of the Cincinnati Fetal Care Center and co-director of the BPD Center.

The BPD team includes specialists in neonatology, pulmonary medicine, radiology and medical imaging, the Heart Institute, the Aerodigestive and Esophageal Center, neurology, respiratory care, nutrition therapy, occupational and physical therapy, and social services. In addition to a multidisciplinary approach, the BPD Center follows a shared care model.

“Since BPD can be a life-long disease, our goal is to improve the immediate and long-term health of the patient by building a customized care plan in partnership with referring physicians and primary care providers,” says Erik Hysinger, MD, co-director of the BPD Center. “By working together as a team we can achieve the best outcomes throughout early childhood and adolescence.”

Cincinnati Children’s is believed to be the only institution in the nation with an MRI scanner within its Neonatal Intensive Care Unit. Using this scanner, which is specially designed for infants, physicians often are able to make earlier and more precise diagnoses. The MRI produces the highest quality images possible of an infant’s lungs, heart and airways -- without exposing them to potentially harmful ionizing radiation.

“These images from MRI can detect subtle differences in mild and more severe disease that allow us to separate components of BPD that can help individualize treatment,” says Jason Woods, PhD, director of the Center for Pulmonary Imaging Research at Cincinnati Children’s and co-director of the BPD Center. “Advanced imaging has the potential to significantly change the understanding and course of this disease and provide avenues for personalized treatments through a combination of new and existing therapies.”

Treatment of BPD is unique for each individual and is geared toward minimizing damage to the lungs and providing enough support to allow an affected infant’s lungs to heal and grow.

The lungs of infants with BDP are underdeveloped and cannot produce enough surfactant, which is a substance secreted in the lungs that keeps the small air sacs (alveoli) from collapsing when an individual exhales. These infants may be treated with surfactant-replacement therapy, which resulted from research conducted at Cincinnati Children’s, and may reduce the development of BPD. Other therapies include tailored medications, nutritional support, oxygen therapy, and mechanical ventilation to support breathing and allow the lungs to grow and develop.

Cincinnati Children’s leads or participates in many clinical trials as part of newborn research groups, such as the National Institute of Child Health and Human Development Neonatal Research Network.