Related Experiment Videos
[Intrapulmonary interstitial emphysema in ventilatorsy supported infants (author's transl)]
Insights
Intrapulmonary interstitial emphysema is a severe complication in newborns, often developing during ventilatory assistance. Its occurrence increases with disease severity and mechanical ventilation, posing significant risks.
Area of Science:
- Neonatal respiratory medicine
- Pediatric pulmonology
- Critical care neonatology
Context:
- Alveolar rupture in newborns can lead to various extraalveolar air collections.
- Intrapulmonary interstitial emphysema (IPIE) is a significant concern in neonatal respiratory distress.
Purpose:
- To investigate the development of intrapulmonary interstitial emphysema (IPIE) and other extraalveolar air collections in newborn infants.
- To determine the relationship between IPIE, gestational age, pulmonary disease severity, and ventilatory assistance mode.
Summary:
- Intrapulmonary interstitial emphysema (IPIE) was identified in 67% of 46 infants studied.
- Development of IPIE was strongly associated with pulmonary disease severity and controlled ventilation (81% incidence).
- Mortality rates were high for infants with IPIE alone (77%) and those with additional air collections (89%).
Impact:
- Intrapulmonary interstitial emphysema (IPIE) is a severe complication requiring careful monitoring in infants receiving ventilatory support.
- Findings highlight the critical role of ventilatory strategy in preventing or exacerbating IPIE.
- This study underscores the need for early recognition and management of IPIE in neonates.
Abstract:
Development of intrapulmonary interstitial emphysema together with other forms of extraalveolar air collections following alveolar rupture was investigated retrospectively in 46 term and preterm newborn infants with respect to gestational age severity of pulmonary disease and mode of ventilatory assistance. Intrapulmonary interstitial emphysema was found in 31 of these 46 infants (67%). Development depended on the severity of pulmonary disease, mode of ventilatory assistance and level of inspiratory pressure. Intrapulmonary interstitial emphysema was found at an average age of 1 day (1-6 days) in 2 out of 23 infants (9%) during unassisted spontaneous breathing, in 8 out of 24 infants (33%) during CPAP and in 21 out of 26 infants (81%) during controlled ventilation. 18 out of these 31 infants (58%) additionally developed other forms of extraalveolar air collections but only in 9 from these interstitial emphysema has been found prior to other forms of extraalveolar air. Mortality rate of infants with intrapulmonary interstitial emphysema alone (10 out of 13; 77%) and infants who additionally developed other forms of extraalveolar air collections (16 out of 18; 89%) did not differ significantly. Development of intrapulmonary interstitial emphysema even in he absence of other forms of extraalveolar air collections has therefore to be judged as a severe complication in infants undergoing different forms of ventilatory assistance.