Asymmetric lung involvement in bronchopulmonary dysplasia.

The radiographic distribution of pulmonary abnormalities in bronchopulmonary dysplasia (BPD) in all previously reported cases has been bilateral and generalized. The authors studied 11 premature infants who had BPD that was primarily unilateral. The striking feature in each of these patients was the occurrence of an episode of prolonged unilateral atelectasis or tension pneumathorax. Few, if any, radiographic manifestations of BPD developed. Results of a detailed analysis of oxygen exposure and respirator therapy during the periods of unequal lung ventilation further characterizes the protective effect of atelectasis and tension pneumothorax in the development of BPD.