Corsini Iuri, Pratesi Simone, Dani Carlo
Section of Neonatology, Department of Surgical and Medical Critical Care, Careggi University Hospital of Florence, University of Florence School of Medicine , Florence , Italy.
J Matern Fetal Neonatal Med. 2014 Oct;27(15):1610-2. doi: 10.3109/14767058.2013.867322. Epub 2013 Dec 16.
Pulmonary interstitial emphysema (PIE) is a frequent complication in preterm-ventilated infants. These newborns have an increased risk of mortality and bronchopulmonary dysplasia. Various treatments for PIE have been proposed: high-frequency ventilation, postural therapy, selective bronchial intubation or surgery. We present an atypical case of a preterm infant with respiratory distress syndrome complicated by pneumothorax, who after recovery and discontinuation of mechanical ventilation, developed unilateral PIE which was treated with selective bronchial intubation.
Selective bronchial intubation and lung ventilation are therapeutic strategies which can promote the regression of PIE. Conservative approach should remain the first choice treatment of unilateral PIE in order to limit surgical procedures, while effort should be made to prevent this iatrogenic complication.
肺间质肺气肿(PIE)是机械通气早产儿常见的并发症。这些新生儿死亡和支气管肺发育不良的风险增加。针对PIE已提出多种治疗方法:高频通气、体位疗法、选择性支气管插管或手术。我们报告1例早产呼吸窘迫综合征合并气胸的非典型病例,该患儿在恢复并停止机械通气后,发生单侧PIE,采用选择性支气管插管治疗。
选择性支气管插管和肺通气是可促进PIE消退的治疗策略。保守治疗应仍是单侧PIE的首选治疗方法,以减少手术操作,同时应努力预防这种医源性并发症。