Related Experiment Video

Updated: Aug 15, 2026

Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs
08:58

Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs

Published on: October 31, 2025

Pulmonary interstitial emphysema and continuous positive airway pressure in a premature infant

Sameer Y Al-Abdi1, Nalini Singhal

  • 1Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.

Saudi Medical Journal
|October 18, 2005
PubMed

Insights

Pulmonary interstitial emphysema (PIE) can occur in spontaneously breathing infants, not just those on mechanical ventilation. This case report details successful management of PIE in a premature infant using high-frequency oscillatory ventilation.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Critical Care

Background:

  • Pulmonary interstitial emphysema (PIE) is traditionally associated with positive pressure mechanical ventilation in neonates.
  • Recent advancements in perinatal care have led to increased survival of premature infants, with a shift in PIE presentation.
  • PIE is now observed in spontaneously breathing infants, posing new clinical challenges.

Observation:

  • A 29-week gestational age infant developed PIE within the first day of life.
  • The infant was initially managed with nasal continuous positive airway pressure (nCPAP).
  • This presentation highlights PIE occurring in a non-ventilated, spontaneously breathing neonate.

Findings:

  • The infant with PIE was successfully treated with high-frequency oscillatory ventilation (HFOV).
  • This case demonstrates the efficacy of HFOV in managing PIE in spontaneously breathing neonates.
  • Early recognition and intervention were crucial for successful management.

Implications:

  • This case expands the understanding of PIE etiology and presentation in the neonatal intensive care unit (NICU).
  • It underscores the need for vigilance for PIE even in spontaneously breathing infants.
  • High-frequency oscillatory ventilation may be a viable treatment option for PIE in this specific population.

Related Concept Videos

Mechanical Ventilation III: Noninvasive Ventilation01:23

Mechanical Ventilation III: Noninvasive Ventilation

Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation (NIPPV)
Chronic Obstructive Pulmonary Disease II: Emphysema01:23

Chronic Obstructive Pulmonary Disease II: Emphysema

Emphysema, a major phenotype of chronic obstructive pulmonary disease (COPD), is characterized by irreversible destruction of alveolar walls and permanent enlargement of distal airspaces. Unlike chronic bronchitis, which primarily affects the airways, emphysema predominantly involves the lung parenchyma, where structural damage leads to airflow limitation.PathophysiologyIt most commonly results from prolonged exposure to cigarette smoke and other toxic gases, particularly cigarette smoke.
Pulmonary Cycle: Exhalation01:17

Pulmonary Cycle: Exhalation

In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
Breathing01:05

Breathing

The process of breathing, inhaling and exhaling, involves the coordinated movement of the chest wall, the lungs, and the muscles that move them. Two muscle groups with important roles in breathing are the diaphragm, located directly below the lungs, and the intercostal muscles, which lie between the ribs. When the diaphragm contracts, it moves downward, increasing the volume of the thoracic cavity and creating more room for the lungs to expand. When the intercostal muscles contract, the ribs...
Chronic Obstructive Pulmonary Disease I: Introduction01:23

Chronic Obstructive Pulmonary Disease I: Introduction

Chronic obstructive pulmonary disease is a common, preventable, and treatable respiratory disorder characterized by persistent symptoms and progressive airflow limitation. This limitation results from a combination of small-airway disease (obstructive bronchiolitis) and parenchymal destruction (emphysema), both driven by chronic inflammation from exposure to harmful particles or gases.The disease includes two main pathological entities: emphysema, marked by destruction of alveolar walls and...
Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features01:24

Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features

Chronic bronchitis is a key phenotype of chronic obstructive pulmonary disease (COPD), characterized by airway-centered inflammation and mucus overproduction. It develops from long-term exposure to harmful particles or gases, most commonly cigarette smoke, which triggers a persistent inflammatory response.Cellular and Structural ChangesInflammation initially affects the large bronchi and later the smaller airways, with infiltration by immune cells, including neutrophils, macrophages, and...