[Localized pulmonary interstitial emphysema. Therapeutic management of 3 cases]

Persistent localized interstitial emphysema (PLIE) is a severe complication of assisted ventilation in the neonatal period. From january 1980 to may 1982, 156 cases of IRDS where treated in our Intensive Care Unit. Three of these patients developed this type of emphysema. The initial management was conservative. In two cases, when high ventilatory pressures, and oxygen concentrations were needed to maintain normal blood gases, lobectomy was performed. In both of them mechanical ventilation could be withdrawn shortly after surgery. The third case was managed with conservative medical therapy, and the patient died. In conclusion, when PLIE is diagnosed and does not resolve with medical therapy, the patient needs increasingly higher oxygen concentrations and ventilatory pressures, or mechanical ventilation can not be withdrawn, lobectomy should be performed as long as the process is well localized.