Pulmonary pseudocysts in newborn infants with respiratory distress syndrome

Pneumatoceles in preterm infants—incidence and outcome in the post-surfactant era

“…12,13,22,23 Our findings were similar in that, all the surviving infants had complete resolution of pneumatoceles after a reduction in ventilator mean airway pressure or extubation. There have been reports of complications of pneumatoceles including, PTX and 19 Recently, there have been case reports of large or multiple pneumatoceles in infants needing interventions by surgical or percutaneous catheter-placed decompression or video-assisted thoracoscopic surgery and pig-tail catheter placement.…”

“…It is able to modulate alveolar surface tension, prevent atelectasis, facilitate mucus clearance, scavenge oxygen radicals, suppress inflammation, and thus reduce the risks of airleaks. 12 Thus, the use of the surfactant was quite possibly an important factor for the decrease in incidence of pneumatoceles in our study compared with the earlier studies. 12,13 The use of positive pressure ventilation has also changed significantly in the last decade with less aggressive use of high peak pressures or tidal volumes and the availability of high-frequency ventilators.…”

“…12 Thus, the use of the surfactant was quite possibly an important factor for the decrease in incidence of pneumatoceles in our study compared with the earlier studies. 12,13 The use of positive pressure ventilation has also changed significantly in the last decade with less aggressive use of high peak pressures or tidal volumes and the availability of high-frequency ventilators. This may be another factor in the decreasing incidence of all intrathoracic air-leaks including pneumatoceles.…”

“…12,13,20,21 All the infants in Clarke's study had PIE and 90% of all infants in Williams' study had PIE. 12,13 However, only 26% of infants in our study had PIE before, or associated with, pneumatoceles. Other air-leak complications such as pneumomediastinum and PTX were also significantly less common in our series.…”

“…The etiology of pneumatoceles includes congenital, 2 traumatic, 3,4 post-infectious, [5][6][7][8][9] hydrocarbon ingestion, 10,11 and ventilator induced. [12][13][14] The most common reports in the literature are in older children and adults associated with post-infectious problems especially Staphylococcal and Klebsiella pneumonia. Neonatal pneumatoceles have mostly been described with ventilator-induced air-leak conditions during the 1970s and 1980s.…”