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Selective intubation in pulmonary interstitial emphysema: experience in five patients
Australian Paediatric Journal
|November 1, 1984
Summary
Selective bronchial intubation offers a potential treatment for severe pulmonary interstitial emphysema (PIE) in infants. This method showed improvement in most cases, suggesting shorter intubation times may suffice.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Respiratory Care
Background:
- Pulmonary interstitial emphysema (PIE) is a severe condition in neonates.
- Localized PIE can cause respiratory distress and hemodynamic compromise.
- Management strategies for severe PIE are limited.
Observation:
- Five infants (9-20 days old) with severe left-sided PIE underwent selective right main bronchus intubation.
- Intubation duration ranged from 4 to 30 hours.
- Radiological evidence of improvement was monitored.
Findings:
- Four out of five infants experienced permanent improvement.
- One infant showed temporary improvement.
- Right upper lobe atelectasis occurred in three cases, irrespective of endotracheal tube design.
Implications:
- Selective bronchial intubation is a viable option for severe, localized PIE in neonates.
- Prolonged intubation beyond radiological improvement may not be necessary.
- This intervention should be reserved for PIE causing respiratory failure or significant pressure effects.