PMID: 592069Dec 1, 1977

"Acquired" lobar emphysema: a complication of respiratory distress in premature infants

Journal of Pediatric Surgery
D R CooneyJ E Allen

Abstract

Ten premature infants with respiratory distress developed a type of pulmonary lobar emphysema that is clinically and histologically distinct from interstitial or congenital lobar emphysema. In eight patients emphysema was noted in the right lower lobe, while in two the left upper lobe was affected. Five infants exhibited nonresolution of the emphysema and an inability to be weaned from ventilator support. Lung scans in these five infants showed absent or markedly decreased perfusion of the involved lobe. Lobectomy was necessary. Postoperatively, their respiratory status improved and they were successfully weaned from the ventilator. Five premature infants with identical radiographic emphysematous changes had normal lung scans. These infants did not require lobectomy and were also successfully weaned from the ventilator. Radiographic changes of lobar emphysema in these five infants completely resolved. Pathologic changes in the excised lobes were characteristic of bronchopulmonary dysplasia and obstructive intraalveolar emphysema. The long-term effects of positive pressure ventilation, oxygen, and suctioning techniques directed toward the right lower lobe may play an important role in the etiology of "acquired" lobar emphysema.

References

Oct 1, 1976·Journal of Pediatric Surgery·K D Anderson, R Chandra
Oct 1, 1973·Journal of Pediatric Surgery·J H GayM E Molthan
Jun 1, 1974·American Heart Journal·R D ZachmanM K Ledbetter
Sep 7, 1972·The New England Journal of Medicine·J A KittermanA M Rudolph
Feb 16, 1967·The New England Journal of Medicine·W H NorthwayD Y Porter
Jul 1, 1970·The Journal of Pediatrics·L M DubowitzC Goldberg

Citations

May 1, 1982·European Journal of Pediatrics·H Zimmermann
Jan 9, 2007·Pediatric Surgery International·E ClubleyD C Crabbe
Jun 24, 2004·Sleep & Breathing = Schlaf & Atmung·Fang HanQuan Y He
Jul 31, 2003·American Journal of Respiratory and Critical Care Medicine·Julian AllenAmerican Thoracic Society
Apr 18, 2006·Journal of Cardiothoracic and Vascular Anesthesia·Ijas MoideenSuresh G Rao
Dec 1, 1987·Journal of Pediatric Surgery·S K GreenholzR H Shikes
Oct 1, 1978·The Journal of Pediatrics·C R BauerC A Poole
Apr 1, 1986·Current Problems in Surgery·S R LuckJ G Raffensperger
Aug 1, 1984·Journal of Pediatric Surgery·L A Martinez-FrontanillaJ D Burrington
Nov 22, 1997·Pediatric Pulmonology·A KugelmanD Bader

Related Concepts

Lung
Lung Volume Reduction
Focal Emphysema
Mechanical Ventilation
Respiratory Distress Syndrome, Newborn

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