Lobectomy with ECMO Support in an Infant Who Developed Pulmonary Interstitial Emphysema Following Repair of...

Area of Science:

• Neonatal Medicine
• Pediatric Surgery
• Respiratory Medicine

Background:

• Pulmonary interstitial emphysema (PIE) is a frequent complication in premature neonates suffering from respiratory distress syndrome.
• It is often associated with barotrauma from mechanical ventilation or continuous positive airway pressure in low birth weight infants.
• Clinical diagnosis of PIE can present significant challenges.

Observation:

• A neonate developed severe PIE with recurrent pneumothoraces and a persistent bronchopleural fistula.
• These complications arose shortly after surgical repair of a hypoplastic aortic arch.
• The infant required extracorporeal membrane oxygenation (ECMO) for circulatory and respiratory support.

Findings:

• A successful surgical intervention involving lobectomy was performed.
• Extracorporeal support (ECMO) was crucial for managing the infant's critical condition during surgery.
• This approach facilitated the resolution of severe PIE and associated complications.

Implications:

• This case highlights the feasibility of surgical management for severe PIE with bronchopleural fistula in neonates.
• The successful use of ECMO underscores its importance in complex pediatric surgical cases.
• Early diagnosis and intervention, including advanced support, are vital for improving outcomes in neonates with PIE and surgical complications.