eMedicine Specialties > Radiology > Pediatrics

Pulmonary Interstitial Emphysema: Follow-up

Author: Beverly P Wood, MD, PhD, Professor Emerita, Departments of Radiology and Pediatrics, Division of Medical Education, Keck School of Medicine, University of Southern California; Professor of Clinical Radiology, Loma Linda University School of Medicine
Contributor Information and Disclosures

Updated: Jun 18, 2008

Intervention

When PIE is localized, it is extremely helpful to selectively ventilate unaffected lung so as to bypass the affected lobe or lobes. Radiologic imaging can assist by determining the location of the endotracheal tube. Radiologic imaging is also useful in monitoring for the potential complication of pneumothorax.

Placing the infant in the decubitus position with the affected side down can be of help when the diagnosis of unilateral PIE is made.9,10,11,12

Medicolegal Pitfalls

  • Because of the high morbidity and mortality associated with PIE, physicians have used various methods to ventilate infants with noncompliant lungs, including inhaled nitrous oxide, high-frequency ventilation, and extracorporeal membrane oxygenation.

See also the Medscape topic Medical Malpractice and Legal Issues.

 


More on Pulmonary Interstitial Emphysema

Overview: Pulmonary Interstitial Emphysema
Imaging: Pulmonary Interstitial Emphysema
Follow-up: Pulmonary Interstitial Emphysema
Multimedia: Pulmonary Interstitial Emphysema
References

References

  1. Cochran DP, Pilling DW, Shaw NJ. The relationship of pulmonary interstitial emphysema to subsequent type of chronic lung disease. Br J Radiol. Dec 1994;67(804):1155-7. [Medline].

  2. Roll C, Hanssler L, Voit T. Case 30-1997: pulmonary interstitial emphysema in infancy [letter; comment]. N Engl J Med. Mar 5 1998;338(10):689-90. [Medline].

  3. Soll, RF, Morley, CJ. Cochrane Database Syst Rev 2001;2:CD000510Prophylactic versus selective use of surfactant in preventing morbidity and mortality in preterm infants. Cochrane Review. 2001;2:CD000510.

  4. Stevens TP, Harrington EW, Blennow M, Soll RF. Early surfactant administration with brief ventilation vs. selective surfactant and continued mechanical ventilation for preterm infants with or at risk for respiratory distress syndrome. Cochrane Database Syst Rev. Oct 17 2007;CD003063. [Medline].

  5. Nelle M, Zilow EP, Linderkamp O. Effects of high-frequency oscillatory ventilation on circulation in neonates with pulmonary interstitial emphysema or RDS [see comments]. Intensive Care Med. Jun 1997;23(6):671-6. [Medline].

  6. Plavka R, Kopecky P, Sebron V. A prospective randomized comparison of conventional mechanical ventilation and very early high frequency oscillatory ventilation in extremely premature newborns with respiratory distress syndrome. Intensive Care Med. Jan 1999;25(1):68-75. [Medline].

  7. Speer CP, Ruess D, Harms K. Neutrophil elastase and acute pulmonary damage in neonates with severe respiratory distress syndrome. Pediatrics. Apr 1993;91(4):794-9. [Medline].

  8. Jabra AA, Fishman EK, Shehata BM. Localized persistent pulmonary interstitial emphysema: CT findings with radiographic-pathologic correlation. AJR Am J Roentgenol. Nov 1997;169(5):1381-4. [Medline].

  9. Ahluwalia JS, Rennie JM, Wells FC. Successful outcome of severe unilateral pulmonary interstitial emphysema after bi-lobectomy in a very low birth weight infant. Journal of the Royal Society of Medicine. March, 1996;89:167-168.

  10. [Best Evidence] Greenough A, Dimitriou G, Prendergast M, Milner AD. Synchronized mechanical ventilation for respiratory support in newborn infants. Cochrane Database Syst Rev. Jan 23 2008;CD000456. [Medline].

  11. Chalak LF, Kaiser JR, Arrington RW. Resolution of pulmonary interstitial emphysema following selective left main stem intubation in a premature newborn: an old procedure revisited. Paediatr Anaesth. Feb 2007;17(2):183-6. [Medline].

  12. Thayyil S, Nagakumar P, Gowers H, Sinha A. Optimal endotracheal tube tip position in extremely premature infants. Am J Perinatol. Jan 2008;25(1):13-6. [Medline].

Further Reading

Keywords

acquired cystic lung disease of the premature infant, barotrauma of the premature lung interstitium, PIE

Contributor Information and Disclosures

Author

Beverly P Wood, MD, PhD, Professor Emerita, Departments of Radiology and Pediatrics, Division of Medical Education, Keck School of Medicine, University of Southern California; Professor of Clinical Radiology, Loma Linda University School of Medicine
Beverly P Wood, MD, PhD is a member of the following medical societies: American Academy of Pediatrics, American Association for Women Radiologists, American College of Radiology, American Institute of Ultrasound in Medicine, American Medical Association, American Roentgen Ray Society, Association of University Radiologists, Radiological Society of North America, and Society for Pediatric Radiology
Disclosure: Nothing to disclose.

Medical Editor

Robert J Starshak, MD, Medical Director, Assistant Clinical Professor, Department of Radiology, Medical College of Wisconsin, Falls Medical Group
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, Resolution Imaging Medical Corporation
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

John Karani, MBBS, FRCR, Clinical Director of Radiology and Consultant Radiologist, Department of Radiology, King's College Hospital, London
John Karani, MBBS, FRCR is a member of the following medical societies: British Institute of Radiology, British Society of Interventional Radiology, Cardiovascular and Interventional Radiological Society of Europe, European Society of Gastrointestinal and Abdominal Radiology, European Society of Radiology, Radiological Society of North America, and Royal College of Radiologists
Disclosure: Nothing to disclose.

 
 
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