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Pulmonary pseudocysts in newborn infants with respiratory distress syndrome
Insights
Neonatal respiratory distress syndrome treated with assisted ventilation can lead to intrathoracic pseudocysts. These cystlike structures often resolve spontaneously in neonates, rarely requiring intervention.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Radiology
Background:
- Respiratory distress syndrome (RDS) is a common neonatal condition.
- Assisted ventilation is a critical treatment for neonatal RDS.
- Pulmonary interstitial emphysema (PIE) is a known complication of assisted ventilation.
Purpose of the Study:
- To describe the occurrence and natural history of intrathoracic pseudocysts in neonates.
- To evaluate the resolution patterns and clinical significance of these pseudocysts.
- To correlate pseudocyst development with other respiratory complications.
Main Methods:
- Retrospective case series of twelve neonates.
- Clinical and radiographic assessment of respiratory distress syndrome.
- Monitoring for development and resolution of intrathoracic pseudocysts.
Main Results:
- All twelve neonates had respiratory distress syndrome and received assisted ventilation.
- Pulmonary interstitial emphysema preceded pseudocyst formation in all cases.
- Ten of twelve neonates showed radiographic resolution of pseudocysts between 3-18 days of age.
- Two neonates had persistent pseudocysts without symptomatic complications or need for surgery.
- Eight neonates developed bronchopulmonary dysplasia, severe in two cases.
Conclusions:
- Intrathoracic pseudocysts are a transient finding in neonates with respiratory distress syndrome and assisted ventilation.
- These pseudocysts typically resolve spontaneously without intervention.
- Pseudocyst resolution may be associated with shifts in extra-alveolar gas.
Abstract:
Twelve neonates who developed intrathoracic cystlike structures ("pseudocysts") are described. All infants had clinical and radiographic respiratory distress syndrome and all were treated with assisted ventilation. Pulmonary interstitial emphysema preceded the development of the pseudocysts in all cases. The pseudocysts appeared between 0 and 6 days of life (average, 2.4 days), and radiographically documented disappearance occurred in 10 patients at 3--18 days old (average, 7.0 days). Two patients had persisting pseudocysts at 8 and 25 days of age, and no subsequent radiographs. In no case did these structures persist symptomatically or require surgical intervention such as has been described with patients in other series. In two cases, abrupt disappearance of the pseudocysts was accompanied by increased extraalveolar gas in other locations. Eight patients developed radiographic bronchopulmonary dysplasia, which was severe in two of the cases.