Kim Changsin, Shin Jeong Eun, Lee Soon Min, Eun Ho Seon, Park Min Soo, Park Kook In, Namgung Ran, Lee Sungsoo, Yoon Choon Sik
Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2016 Nov;57(6):1523-6. doi: 10.3349/ymj.2016.57.6.1523.
The pulmonary interstitial emphysema (PIE) is a life-threatening illness in premature infants with mechanical ventilation. While most are managed conservatively, decompression would be necessary. Here, we report the first case of PIE treated by percutaneous catheter insertion in an extremely low birth weight (ELBW) infant in Korea. The patient, born with 660 g in 23+2 weeks of gestation, showed PIE in left lower lung on postnatal day 12. Percutaneous catheter insertion was performed on postnatal day 25. The size of PIE decreased, but didn't disappear completely. On postnatal day 42, we exchanged catheter and inserted additional catheter in pleural space. However, sudden desaturation and pneumothorax occurred on postnatal day 44. We changed catheter in pleural space, and pneumothorax and PIE improved. Finally, we successfully removed catheters, and weaned patient out. As in our case, percutaneous catheter insertion would be a useful option for ELBW infants with PIE.
肺间质气肿（PIE）是机械通气的早产儿的一种危及生命的疾病。虽然大多数病例采用保守治疗，但减压是必要的。在此，我们报告韩国首例极低出生体重（ELBW）婴儿经皮导管插入术治疗PIE的病例。该患者孕23⁺²周出生，体重660克，出生后第12天左下肺出现PIE。出生后第25天行经皮导管插入术。PIE面积减小，但未完全消失。出生后第42天，我们更换导管并在胸腔内插入额外导管。然而，出生后第44天突然出现低氧血症和气胸。我们更换胸腔内导管后，气胸和PIE情况改善。最终，我们成功拔除导管，使患儿顺利脱机。就像我们的病例一样，经皮导管插入术对于患有PIE的ELBW婴儿将是一种有用的选择。
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