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Lung volume reduction surgery in preterm infants with bronchopulmonary dysplasia. A case report

Jan de Laffolie1, Markus Hirschburger2, Jürgen Bauer3

  • 1Department General Pediatrics and Neonatology, Childrens Hospital, University Giessen Giessen, Germany.

Clinical Case Reports
|October 31, 2014
PubMed

Insights

Lung volume reduction surgery offered initial recovery for a preterm infant with severe bronchopulmonary dysplasia and emphysema. However, respiratory failure recurred two years later, highlighting the complexity of surgical interventions for this condition.

Area of Science:

  • Pediatric Pulmonology
  • Thoracic Surgery
  • Medical Imaging

Background:

  • Severe bronchopulmonary dysplasia (BPD) and lobar emphysema in preterm infants can lead to respiratory failure.
  • Pulmonary arterial hypertension is a serious complication associated with BPD.
  • Maximal conservative treatment often proves insufficient for advanced BPD with emphysema.

Observation:

  • A 9-month-old preterm infant presented with respiratory failure due to severe BPD and large lobar emphysema.
  • The condition compromised ventilation and was associated with pulmonary arterial hypertension.
  • Initial treatment involved maximal conservative measures, followed by bilateral lung volume reduction surgery.

Findings:

  • The infant showed initial recovery post-surgery, indicating potential short-term benefits of lung volume reduction.
  • However, respiratory failure recurred two years after the surgery, suggesting limitations of the intervention.
  • Magnetic Resonance Imaging (MRI)-Angiography posed challenges for initial assessment and surgical planning.

Implications:

  • Bilateral lung volume reduction surgery may provide temporary relief but is not a definitive cure for severe BPD-related emphysema.
  • Complex cases necessitate a multidisciplinary approach involving pulmonologists, surgeons, and radiologists.
  • Advanced imaging techniques and careful patient selection are crucial for optimizing surgical outcomes in pediatric lung disease.
Abstract

Keywords:
Bronchopulmonary dysplasiaemphysemaprematuritysurgery

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