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Updated: Aug 8, 2026

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
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Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus

Published on: March 6, 2019

Preferential distribution of lobar emphysema and atelectasis in bronchopulmonary dysplasia

F M Moylan, D C Shannon

    Pediatrics
    |January 1, 1979
    PubMed

    Insights

    Bronchopulmonary dysplasia (BPD) in neonates can cause right lower lobe hyperinflation and right upper lobe collapse. This condition, often linked to emphysema, typically resolves with supportive care.

    Area of Science:

    • Neonatal Medicine
    • Pediatric Pulmonology
    • Radiology

    Background:

    • Mechanical ventilation is crucial for neonates with respiratory distress syndrome and prolonged apnea.
    • Bronchopulmonary dysplasia (BPD) is a significant complication in infants requiring prolonged ventilation.
    • Specific radiographic patterns, including lobar hyperinflation and atelectasis, are observed in BPD.

    Purpose of the Study:

    • To investigate the characteristics and implications of lobar hyperinflation and atelectasis in neonates with BPD.
    • To differentiate the causes of hyperinflation in BPD, distinguishing it from compensatory mechanisms.
    • To evaluate the temporal course and potential complications of these lung abnormalities.

    Main Methods:

    • Retrospective review of chest roentgenograms from 142 neonates who underwent mechanical ventilation.
    • Identification of infants with bronchopulmonary dysplasia (BPD) and specific lobar abnormalities.
    • Regional lung function assessment using xenon 133 in a subset of patients.

    Main Results:

    • 17 out of 37 infants with BPD exhibited right lower lobe hyperinflation and right upper lobe collapse.
    • Xenon 133 studies indicated reduced ventilation in the lower lung regions, suggesting emphysema rather than compensatory hyperinflation.
    • Regional perfusion was uniform, and the lobar emphysema with ipsilateral atelectasis typically resolved within eight weeks, with minimal association with pneumonia.

    Conclusions:

    • Right lower lobe hyperinflation and right upper lobe collapse in BPD are associated with emphysema.
    • These radiographic findings in BPD have a characteristic presentation and resolution pattern.
    • Supportive care is the recommended management approach for these BPD-related lung abnormalities.

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