Diagnosing Chronic Lung Disease of Prematurity

Neonatologists at Hassenfeld Children’s Hospital at NYU Langone are experienced in identifying chronic lung disease of prematurity, a condition in which inflammation and scarring in a baby’s lungs interfere with breathing and the absorption of oxygen, which in turn affects oxygen levels in the blood (known as oxygen saturation). Babies are considered to have chronic lung disease if they were born prematurely—before week 37 of pregnancy—and still have breathing problems that require oxygen and respiratory support after what would have been week 36 of pregnancy.

Causes of Chronic Lung Disease in Babies

Respiratory distress syndrome, a condition seen in premature infants with underdeveloped lungs, is the biggest risk factor for chronic lung disease. Some babies with respiratory distress syndrome require intensive treatment with a mechanical ventilator that supplies oxygen to the baby’s lungs. Although lifesaving, mechanical ventilation and high levels of oxygen can contribute to the development of chronic lung disease in premature babies with fragile lungs.

Babies with a birth weight of less than 4.5 pounds or severe respiratory infections shortly after birth also have a greater risk of developing chronic lung disease. Less commonly, older babies and children can develop chronic lung disease after an infection or other lung problems.

Babies with chronic lung disease have difficulty breathing on their own. They may also have a hard time gaining weight and growing, which can slow recovery of their lungs. Babies with chronic lung disease are especially vulnerable to pneumonia and other lung infections.

Our neonatologists perform a specialized physical exam and other tests to determine the severity of the condition.

Physical Exam

During a physical exam, your child’s doctor uses a stethoscope to listen for unusual breathing sounds, such as wheezing, and examines your baby for signs of insufficient oxygen, such as bluish skin and rapid or unusual movement of the muscles involved in breathing.

Peripheral Pulse Oximetry

A peripheral pulse oximeter is a device that measures the oxygen level of your baby’s blood. The device consists of a small sensor placed on your baby’s fingertip with a painless clip. This sensor uses the light-absorbing properties of hemoglobin—a substance in the blood that contains oxygen, which makes blood red—and the baby’s pulse to measure how much oxygen is in the blood.

Chest X-ray

A chest X-ray provides a picture of the baby’s lungs to check for signs of inflammation, scarring, or underdevelopment. An X-ray can also reveal a buildup of fluid in the lungs called pulmonary edema.

Accurately diagnosing chronic lung disease is important in order to identify the most appropriate treatment and to help your baby recover quickly.