Lobectomy with ECMO Support in an Infant Who Developed Pulmonary Interstitial Emphysema Following Repair of Hypoplastic Aortic Arch

Magarakis, Michael; Nguyen, Dao M.; Macias, Alejandro E.; Rosenkranz, Eliot R.

doi:10.21470/1678-9741-2018-0135

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…Steroid administration of hydrocortisone was shown to markedly improve and then resolve a case of refractory PIE when conventional therapeutic treatment was not successful 24. If conservative treatment is not successful, a lobectomy should be considered 25,26…”

Section: Treatment and Management Of Air Leaksmentioning

confidence: 99%

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Management of Air Leaks in the Newborn

Kastein¹,

Coe²

2023

Advances in Neonatal Care

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Background: Air leaks, especially pulmonary interstitial emphysema (PIE), are increasingly uncommon respiratory complications of the newborn. Despite PIE having a decreasing incidence, it continues to have a high morbidity and mortality rate. This makes PIE one of the most severe respiratory complications to affect a newborn. Air leaks occur when there is overdistension of the terminal airways or alveoli, which results in air dissecting into extra-alveolar spaces. Recognizing the signs of air leaks is paramount to allow for appropriate diagnosis and treatment of the newborn to improve morbidity and mortality. Treatment modalities range from positioning the newborn in the decubitus position to surgical intervention. Purpose: To summarize current evidence on the pathophysiology, risk factors, diagnosis, treatment, and management of PIE and pneumothorax. Data Sources: Two databases were systematically reviewed with key words later. Articles in English with date restrictions from 2016 to current were included. Study Selection: Inclusion criteria of randomized controlled trials, case studies/reports, and review articles were utilized. Twenty articles, primarily case reports and studies, were reviewed. Data Extraction: Guidelines for data abstraction were followed via independent extraction by a single observer. Results: Qualitative results were utilized to formulate current treatment of air leaks. Implications for Practice: This article provides guidance for frontline neonatal providers on current treatment and management of air leaks in the newborn population.

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Section: Treatment and Management Of Air Leaksmentioning

confidence: 99%

“…24 If conservative treatment is not successful, a lobectomy should be considered. 25,26 Treatment for Pneumothorax An older treatment of pneumothorax was to perform nitrogen washout therapy. The newborn would receive 100% oxygen for 8 to 12 hours to reduce the partial pressure of the nitrogen in the alveoli.…”

Section: Treatment For Piementioning

confidence: 99%

Management of Air Leaks in the Newborn

Kastein¹,

Coe²

2023

Advances in Neonatal Care

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A Case of Pulmonary Interstitial Emphysema and Systematic Review of Literature in Management Approach

La Regina,

Arena,

Riccardi

et al. 2023

CRMR

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Background: Pulmonary interstitial emphysema (PIE) is a rare pathology characterized by the abnormal and harmful presence of air in the interstitial tissues of the lung. This condition is often related to barotrauma caused by mechanical ventilation, but it can be exceptionally seen in healthy infants. The main causes of PIE are respiratory distress syndrome (RDS), mechanical ventilation or positive pressure ventilation, prematurity, meconium aspiration syndrome, pulmonary infection, amniotic fluid aspiration, and incorrect endotracheal tube placement. To date, there is no standard treatment for PIE, based on the clinical and localization of PIE conservative and non-conservative therapies are described. Methods: We describe a case of a very premature infant with severe respiratory failure secondary to RDS and unilateral left sided PIE with lung herniation treated with conservative therapy like selective intubation, steroid therapy, lateral position, and lastly, oxygen supplementation without ventilatory assistance. Furthermore, we have carried out a systematic literature review for the past 15 years (2007-2022). A systematic review, using an evidence-based algorithmic approach, was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Our search, after the selection, produced a total of 24 articles, which were revised. Conclusion: In our case oxygen supplementation without ventilatory assistance resulted in successful resolution of the left PIE. Discontinuation of ventilatory care played a crucial role. Considering the management reported in literature, our aim is to perform a systematic literature review by adding our experience to the available knowledge on therapy for unilateral PIE.

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Lobectomy with ECMO Support in an Infant Who Developed Pulmonary Interstitial Emphysema Following Repair of Hypoplastic Aortic Arch

Cited by 2 publications

References 5 publications

Management of Air Leaks in the Newborn

Management of Air Leaks in the Newborn

A Case of Pulmonary Interstitial Emphysema and Systematic Review of Literature in Management Approach

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