Abstract
IntroductionPulmonary interstitial emphysema is a serious complication of mechanical ventilation and can become life-threatening if progression occurs. Therapeutic lung puncture is a treatment option for severe pulmonary interstitial emphysema but has a limited use in babies with extremely low birth weight. We present a case of pulmonary interstitial emphysema in a Japanese baby (1-day-old) boy with extremely low birth weight. The emphysema was successfully decompressed by therapeutic lung puncture performed with a trocar catheter.Case presentationThe baby was born with a weight of 420g, which, to the best of our knowledge, is the lowest reported birth weight among babies with pulmonary interstitial emphysema. A chest X-ray on postnatal day 2 revealed pulmonary interstitial emphysema, which gradually progressed to diffuse pseudocystic changes. His condition became life-threatening despite the use of high-frequency oscillatory ventilation and lateral decubitus positioning. We evacuated the pulmonary interstitial emphysema by lung puncture with a trocar catheter to avoid respiratory and cardiovascular collapse. This resulted in adequate evacuation of the emphysema and a dramatic improvement in his clinical condition.ConclusionsTherapeutic lung puncture performed with a trocar catheter is beneficial in babies with extremely low birth weight and diffuse pulmonary interstitial emphysema. This treatment option may be broadly applicable, especially in an emergency situation.
Highlights
Pulmonary interstitial emphysema is a serious complication of mechanical ventilation and can become life-threatening if progression occurs
Therapeutic lung puncture performed with a trocar catheter is beneficial in babies with extremely low birth weight and diffuse pulmonary interstitial emphysema
Therapeutic lung puncture has been described as a treatment for severe Pulmonary interstitial emphysema (PIE)
Summary
Therapeutic lung puncture with a trocar catheter may be a useful treatment option for diffuse PIE, even in babies with ELBW. This treatment option may be broadly applicable, especially in an emergency medical condition. Consent Written informed consent for publication of this case report and any accompanying images was obtained from the patient’s parents. A copy of the written informed consent is available for review by the Editor-in-Chief of this journal. Competing interests The authors declare that they have no competing interests. Authors’ contributions MW wrote the first draft of the manuscript. NM and MH revised the manuscript and contributed to its concept. All authors read and approved the final manuscript
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