Successful therapy of unilateral pulmonary emphysema: mechanical ventilation with extremely short inspiratory time

We describe a novel approach to the mechanical ventilation of two neonates with life-threatening unilateral pulmonary emphysema (UPE). Using a standard time-cycled, pressure-limited ventilator, we achieved resolution of UPE with shorter inspiratory times than previously reported effective in human newborns (0.10-0.15 sec). We elected this ventilatory strategy in order to direct tidal volume preferentially toward units of lung with relatively normal time constants, while avoiding inflation of longer time-constant emphysematous areas.