Diffuse persistent pulmonary interstitial emphysema secondary to mechanical ventilation in bronchiolitis
| Autor: | Isabel Gordillo, Maria José Solana García, Jesús López-Herce Cid, Blanca Toledo del Castillo, Sarah Fernández Lafever, Elena Rubio García, J.L. Gonzalez, Javier Urbano Villaescusa, Rafael González Cortés |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_treatment Case Report 03 medical and health sciences 0302 clinical medicine Mechanical ventilation Extracorporeal Membrane Oxygenation 030225 pediatrics Neonatal medicine Diffuse persistent interstitial emphysema Humans 030212 general & internal medicine Cardiopulmonary resuscitation Renal replacement therapy Respiratory system Lung business.industry Infant Newborn Pulmonary interstitial emphysema respiratory system medicine.disease Respiration Artificial respiratory tract diseases medicine.anatomical_structure Pulmonary Emphysema Bronchiolitis Anesthesia Radiography Thoracic ECMO business Respiratory Insufficiency Tomography X-Ray Computed Rare disease |
| Zdroj: | BMC Pulmonary Medicine Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid Consejería de Sanidad de la Comunidad de Madrid |
| ISSN: | 1471-2466 |
| Popis: | Background Persistent interstitial pulmonary emphysema (PIE) is a rare disease and it is even more uncommon in full-term infants, like our patient. When conservative management is not successful, surgical treatment should be considered. In our case, ECMO support was iniciated to keep the patient ventilated in order to allow the lung to heal using lung protection strategies. Case presentation We report an 18-day-old male infant with bronchiolitis that required mechanical ventilation with high positive airway pressures due to severe respiratory insufficiency. Chest X-rays and computed tomography scan revealed a severely hyperinflated left lung with extensive destructive changes and multiple small bullae. These findings were consistent with diffuse persistent interstitial emphysema (PIE), probably due to mechanical ventilation. The patient required high frequency oscillatory ventilation, inotropic support and continuous renal replacement therapy. He eventually suffered a cardiac arrest that required cardiopulmonary resuscitation and ECMO during 5 days with progressive clinical improvement and normalization of the X-ray. Conclusion We present a patient with diffuse persistent interstitial emphysema who, despite an unfavorable evolution with different mechanical ventilation strategies, had a good response after ECMO assistance. |
| Databáze: | OpenAIRE |
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