Related Experiment Video
Updated: May 6, 2026
06:15
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
53.3K
Ventricular septal defect complicated by infantile lobar emphysema
Tomohiro Nakata1, Tadashi Ikeda, Hiroshi Date
1Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Summary
A five-month-old infant with Down syndrome and heart defects underwent successful surgical repair of cardiac anomalies and removal of the right upper lobe due to emphysema. The infant recovered well, was extubated on day 12, and discharged on day 29.
Area of Science:
- Pediatric Cardiology
- Thoracic Surgery
- Clinical Case Study
Background:
- Infants with Down syndrome (trisomy 21) often present with congenital heart defects such as ventricular septal defect and atrial septal defect.
- Infantile lobar emphysema is a rare congenital lung malformation that can lead to respiratory failure.
Observation:
- A five-month-old infant with trisomy 21, ventricular septal defect, and atrial septal defect developed progressive infantile lobar emphysema of the right upper lobe.
- The infant required mechanical ventilator support due to respiratory compromise.
Findings:
- A combined surgical procedure was successfully performed, including total correction of cardiac anomalies and right upper lobectomy.
- The lobectomy was conducted under cardiopulmonary bypass via median sternotomy without significant complications like airway bleeding or mediastinitis.
Implications:
- This case demonstrates the feasibility and safety of combined cardiac and pulmonary surgical intervention in complex pediatric cases.
- Successful management of infantile lobar emphysema in conjunction with congenital heart disease can lead to improved respiratory and overall patient outcomes.
Related Concept Videos
01:23Chronic Obstructive Pulmonary Disease II: Emphysema
155
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.
155
01:08Pneumothorax II: Pathophysiology
108
Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance...
108
01:17Pulmonary Cycle: Exhalation
5.5K
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...
5.5K
01:10Atelectasis II: Pathophysiology
75
Atelectasis develops when alveoli lose their air and collapse inward. Because lung tissue is naturally elastic, these air sacs shrink rather than remaining open. Collapsed alveoli are no longer ventilated, reducing their role in gas exchange. Blood flow may continue in these regions, creating a ventilation–perfusion mismatch. Clinical findings include decreased breath sounds, dullness to percussion, reduced chest expansion, and decreased tactile fremitus as sound transmission through...
75
01:18Pulmonary Edema II: Pathophysiology
76
Pulmonary edema is the accumulation of fluid in the interstitial and alveolar spaces of the lungs, impairing gas exchange and oxygen delivery. It may be cardiogenic or noncardiogenic, but both reduce oxygenation and lung compliance.Cardiogenic Pulmonary EdemaCardiogenic edema results from increased hydrostatic pressure in pulmonary capillaries, usually due to left ventricular dysfunction from myocardial infarction, heart failure, or valvular disease. Ineffective cardiac pumping causes blood to...
76
01:05Breathing
50.7K
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...
50.7K