Pneumatoceles in preterm infants—incidence and outcome in the post-surfactant era

Successful percutaneous drainage of pneumatoceles in an extremely low-birthweight infant

“…Organisms implicated in pneumatocele formation are S. aureus , Streptococcus pneumoniae , Escherichia coli , Klebsiella pneumoniae , Enterobacter cloacae and Pseudomonas aeruginosa 4. Conservative management along with ventilation at low mean airway pressure leads to resolution of pneumatocele in most of the mild to moderate cases 2. However, severe pathologies causing respiratory failure or haemodynamic compromise need urgent intervention.…”

“…In the presurfactant era due to high pressures, all kinds of air leaks including pneumatoceles were fairly common. However, in the current era with the advent of surfactant and gentle ventilation strategies, incidence of pneumatoceles has decreased significantly 2. The aetiology of pneumatoceles may be infectious, traumatic, congenital or positive pressure ventilation induced.…”

“…The aetiology of pneumatoceles may be infectious, traumatic, congenital or positive pressure ventilation induced. In older age groups, postinfectious pneumatocele is common in contrast with neonates where ventilator-induced pneumatocele is the most common aetiology 2. There is very limited data on postinfectious pneumatoceles in neonates due to its relatively rare nature 3.…”

Cystic Lung Lesions in Newborns and Young Children: Differential Considerations and Imaging

“…14). 27 PIE is often the harbinger of other air leak phenomena as air dissects and breaks through to the mediastinal, pleural, pericardial, or even peritoneal space. When plain film radiographs are confusing, CT can often define the location, extent, and nature of the air.…”

Decreasing mean airway pressure as a management strategy for tension pneumatocoeles

“…The hypothesis that high mean airway pressure drives accumulation of pneumatocoeles3 guided our approach of lowered continuous positive airway pressure (weaning from 5 cm H 2 O to 3 cm H 2 O over 7 days) and dexamethasone administration (0.25 mg/kg/day for 3 days, weaning over 6 days) to reduce inflammation 1. Within 2 weeks, the right-sided pneumatocoele had resolved; 6 months later both lungs were normal (figure 1D, E).…”