One‐sided high‐frequency oscillating ventilation in the treatment of neonatal unilateral pulmonary emphysema

Abstract

We describe a preterm infant (31 weeks' gestation) with unilateral pulmonary emphysema. Bronchoscopy showed no bronchial obstruction. After 20 days of right-sided high-frequency oscillating ventilation, the emphysema in the left lung had completely resolved and the patient could be extubated.

Pneumothorax and pulmonary intersticial emphysema: treatment with selective bronchial occlusion and high frequency ventilation

“…A ventilação de alta freqüência unilateral tem sido aplicada com sucesso no tratamento de enfisema pulmonar intersticial, cistos pulmonares adquiridos e enfisema lobar congênito grave 1,2,10 .…”

“…A ocorrência de enfisema intersticial, embora não represente risco imediato à vida, contribui para o aumento da morbidade pulmonar nos recém-nascidos submetidos à ventilação pulmonar mecânica. Tem sido descrita na literatura a utilização com sucesso, em alguns pacientes, da ventilação de alta freqüência (VAF) e da ventilação de alta freqüência ventilatória (VAFO) através da intubação seletiva do brônquio fonte do pulmão menos comprometido e não afetado pelo pneumotórax 1,2 .…”

Selektive Bronchusintubation bei einseitigem interstitiellen Emphysem

“…In der Literatur finden sich hierfür Angaben zwischen 3 h [15] und 5 Tagen [3]. Bei Anwendung der Hochfrequenzoszillationsbeatmung, die bereits 1983 beim beidseitigen interstitiellen Emphysem angewandt wurde [7], sind selektive Beatmungszeiten von bis zu 20 Tagen beschrieben worden [14]. In jedem Fall ist die vorgestellte Behandlungsform eine sinnvolle und wenig rezidivanfällige Alternative zu invasiven Methoden wie der extrakorporalen Membranoxygenierung und der Lobektomie.…”

Therapeutic Lung Puncture for Diffuse Unilateral Pulmonary Interstitial Emphysema in Preterm Infants

“…PIE is generally considered to be a result of positive pressure ventilation on the immature lung, but it has also been reported in preterm infants who breathed spontaneously, supported only by nasal continuous positive airway pressure [2,5]. Treatment options for PIE have included high inspired oxygen concentrations [7], selective intubation of the less affected lung [9], lateral positioning [11], high-frequency ventilation [6], and steroid treatment [4]. Surgical resection of the affected lobe or lobes has been shown to be an effective treatment for localized pulmonary interstitial emphysema when nonsurgical measures fail [10].…”

“…For the treatment of diffuse PIE -a condition that might be reversible -a conservative, expectant approach is generally preferable and might save the infant's lung. Successful treatment of PIE has been reported with selective intubation of the less affected lung [9], lateral positioning [11], high-frequency oscillation ventilation [6], and systemic steroids [4]. If conventional treatment failed, surgical resection of the affected lobe or lobes has been shown to be an effective treatment for localized PIE in selected cases [10].…”