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Updated: Aug 18, 2026

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
06:15

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

Published on: March 6, 2019

Persistent interstitial pulmonary emphysema: another complication of the respiratory distress syndrome

J T Stocker, J E Madewell

    Pediatrics
    |June 1, 1977
    PubMed

    Insights

    Persistent interstitial pulmonary emphysema (PIPE) in infants can be localized or diffuse. Localized PIPE showed better outcomes with surgical resection, while diffuse PIPE led to high mortality, often with bronchopulmonary dysplasia.

    Area of Science:

    • Neonatal Medicine
    • Pediatric Pulmonology
    • Pathology

    Background:

    • Persistent interstitial pulmonary emphysema (PIPE) is a rare neonatal respiratory condition.
    • Neonatal respiratory distress syndrome (RDS) is a common precursor, often treated with mechanical ventilation and oxygen therapy.

    Purpose of the Study:

    • To describe the clinical presentation, management, and outcomes of persistent interstitial pulmonary emphysema (PIPE) in neonates.
    • To differentiate between localized and diffuse forms of PIPE and their associated prognoses.

    Main Methods:

    • Retrospective review of 22 infants diagnosed with PIPE during the neonatal period.
    • Analysis of treatment strategies including artificial ventilation, oxygen therapy, and surgical resection.
    • Histological examination of lung tissue.

    Main Results:

    • 21 of 22 infants received treatment for respiratory distress syndrome.
    • Ten infants had localized PIPE; 7 underwent successful lung resection, and 3 died.
    • Twelve infants had diffuse PIPE, with 11 developing bronchopulmonary dysplasia due to prolonged oxygen use; all 12 died.
    • Histology revealed air-filled interstitial cysts, sometimes lined by giant cells.

    Conclusions:

    • Localized PIPE may be effectively treated with surgical resection, offering a survival advantage.
    • Diffuse PIPE carries a poor prognosis, frequently complicated by bronchopulmonary dysplasia and leading to mortality.
    • Histological features of interstitial cysts are characteristic of PIPE.

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