Related Experiment Video

Updated: Nov 4, 2025

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

4

Refractory Pulmonary Interstitial Emphysema in Extreme Premature Newborn

Mahmoud Ali1, Lea Mallett1, Greg Miller1

  • 1Department of Pediatrics, Texas A&M Health Science Center, Baylor Scott & White McLane Children's Medical Center, Temple, Texas.

AJP Reports
|May 31, 2021
PubMed

Insights

Pulmonary interstitial emphysema (PIE) in neonates can be challenging to manage. Selective right lung ventilation for two weeks successfully treated a premature infant with severe persistent PIE after other methods failed.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Critical Care Medicine

Background:

  • Pulmonary interstitial emphysema (PIE) is a lung condition caused by air leakage into the interstitium, primarily affecting neonates with respiratory distress syndrome requiring positive pressure ventilation.
  • While often associated with mechanical ventilation, PIE can also occur in spontaneously breathing infants.

Observation:

  • This report details a case of an extremely low birth weight infant experiencing severe and persistent PIE.
  • The infant required multiple forms of invasive mechanical ventilation, including high-frequency oscillatory ventilation, high-frequency jet ventilation, and neurally adjusted ventilatory assist.

Findings:

  • Conventional treatments, such as brief periods of right mainstem intubation, were unsuccessful in managing the infant's condition.
  • A prolonged 2-week trial of selective right lung ventilation proved to be a successful therapeutic strategy.

Implications:

  • Selective lung ventilation can be an effective treatment for severe, persistent PIE in extremely low birth weight infants when conservative measures fail.
  • This approach offers a potential alternative for managing complex respiratory complications in critically ill neonates.

Keywords:
air leak syndromeprematuritypulmonary interstitial emphysemarespiratory distressselective intubation

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