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Successful resolution of unilateral pulmonary interstitial emphysema in a premature infant by selective bronchial
1Department of Pediatrics, Lady Davis Carmel Hospital, Haifa, Israel.
Insights
Pulmonary interstitial emphysema (PIE) in premature infants can cause severe breathing issues. A novel balloon catheter technique successfully treated a case of unilateral PIE, avoiding more invasive procedures.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Medical Devices
Background:
- Pulmonary interstitial emphysema (PIE) is a frequent complication in premature infants with respiratory distress syndrome.
- Unilateral PIE presents a significant challenge, potentially leading to severe respiratory compromise.
- Existing treatments for unilateral PIE vary, with some conservative methods showing limited success.
Abstract:
Pulmonary interstitial emphysema (PIE) is a common complication in premature infants with respiratory distress syndrome. The development of pulmonary interstitial emphysema leads to marked respiratory embarrassment in an already compromised infant. Although usually bilateral, PIE may be unilateral. Various forms of treatment for unilateral PIE in the premature infant have been described, including selective bronchial intubation, unilateral pneumonectomy, visceral pleurotomy, pure oxygen administration, and high-frequency low-pressure ventilation. A recently reported conservative regimen consisting of downward lateral positioning of the affected lung for several days may not be successful. We describe a premature infant with progressive worsening of unilateral PIE, which was successfully treated by selective bronchial balloon catheterization after failure of conservative management. In this manner, we avoided selective bronchial intubation or other aggressive forms of treatment.
