Sevil BİLİR GÖKSÜGÜR, Mervan BEKDAŞ, Gökçe KAYA, Nuriye TARAKÇI, Hüseyin ALTUNHAN, Fatih DEMİRCİOĞLU

Premature Bebekte Pulmoner İnterstisyel Amfizem

Pulmoner interstisyel amfizem genellikle yenidoğanlarda aralıklı pozitif basınçlı ventilatör izleminin bir komplikasyonu olarak gelişen peribronşial- perialveolar hava kaçağı sendromudur. Havanın normal hava yolları dışında, peribronkovasküler kılıfın konnektif dokusu, interlobuler septa ve visseral plevrada birikmesidir. Sıklıkla yenidoğan döneminde, özellikle de respiratuar distres sendromu nedeniyle ventilatör desteğine ihtiyaç duyan prematüre bebeklerde görülür. Birincil tedavi yöntemleri lateral dekübit pozisyonu, selektif bronşial entübasyon ve yüksek frekanslı ventilasyondur. Ventilatör desteği alan, solunum yetersizliği bulunan yenidoğanlarda yüksek mortalite ve morbiditesinden dolayı pulmoner interstisyel amfizem akılda tutulmalıdır. Burada yenidoğan yoğun bakım ünitesindeki izleminin 9. gününde pulmoner interstisyel amfizem gelişen ileri derecede düşük doğum ağırlıklı bebek hasta sunulmuştur.

Anahtar Kelimeler:

Hava kaçağı sendromu, pnömotoraks, prematurite, pulmoner interstisyel amfizem

Pulmonary Interstitial Emphysema In Preterm Baby

Pulmonary interstitial emphysema is a peribronchial, perialveolar air-leakage syndrome that usually develops as a complication of intermittent positive pressure ventilation in neonates. It is a collection of gases outside of the normal air passages and inside the connective tissue of the peribronchovascular sheaths, interlobular septa, and visceral pleura. It occurs most commonly in the newborn period especially in preterm infants with respiratory distress syndrome who require mechanical ventilation. The principal therapies are lateral decubitus positioning, selective bronchial intubation, and high-frequency ventilation. Pulmonary interstitial emphysema which has high mortality and morbidity rates should be kept in mind in newborns with respiratory disabilities who take mechanical ventilatory support. We reported an extremely very low birth weight baby who developed pulmonary interstitial emphysema on ninth day of life in neonatal intensive care.

Keywords:

Air-leakage syndrome, pneumothorax, prematurity, pulmonary interstitial emphysema,

PDF

___

Madansky DL, Lawson EE, Chernick V, Taeusch HW Jr. Pneumothorax and other forms of pulmonary air leak in newborns. Am Rev Respir Dis 1979; 120: 729-737.
Lerman-Sagie T, Davidson S, Wielunsky E. Pulmonary interstitial emphysema in low birth weight infants: characteristics of survivors. Acta Paediatr Hung. 1990;30(3-4):383.
Yu VY, Wong PY, Bajuk B, Szymonowicz W. Pulmonary interstitial emphysema in infants less than 1000 g at birth. Aust Paediatr J. 1986;22(3):189.
Türkmen M, Altıncık A, Acar, Tosun A, Aydoğdu A. Adnan Menderes Üniversitesi Tıp Fakültesi yenidoğan yoğun bakım ünitesinde izlenen çok düşük doğum ağırlıklı bebeklerin değerlendirilmesi. Adnan Menderes Üniversitesi Tıp Fakültesi Dergisi 2006;7: 3-6.
Bawa P, Soontarapornchai K, Perenyi A, Goldfisher R, Amodio J. Development of Localized Pulmonary Interstitial Emphysema in a Late Preterm Infant without Mechanical Ventilation. Case RepPediatr.2014:429797.
Bas AY, Okumus N, Demirel N, Zenciroglu A. Persistent pulmonary interstitial emphysema in a preterm infant. Indian Pediatr. 2008;45(9):775-7.
Stocker JT, Madewell JE. Persistent interstitial pulmonary emphysema: another complication of the respiratory distress syndrome. Pediatrics 1977;59:847-857.
Oh MH, Kim MY, Oh SS, Shin BK, Cho SJ, Kim HK. A case of localized persistent interstitial pulmonary emphysema. J Korean Med Sci 2001;16:225-228.
Cohen MC, Drut RM, Drut R. Solitary unilocular cyst of the lung with features of persistent interstitial pulmonary emphysema: report of four cases. Pediatr Dev Pathol 1999; 2: 531-536.
Matta R, Matta J, Hage P, Nassif Y, Mansour N, Diab N. Diffuse persistent interstitial pulmonary emphysema treated by lobectomy. Ann Thorac Surg. 2011;92(4):e73-5.
Jassal MS, Benson JE, Mogayzel PJ Jr. Spontaneous resolution of diffuse persistent pulmonary interstitial emphysema. Pediatr Pulmonol. 2008;43(6):615-9.
Joseph LJ, Bromiker R, Toker O, Schimmel MS, Goldberg S, Picard E. Unilateral lung intubation for pulmonary air leak syndrome in neonates: a case series and a review of the literature. Am J Perinatol. 2011;28(2):151-6.
Rastogi S, Gupta A, Wung JT, Berdon WE. Treatment of giant pulmonary interstitial emphysema by ipsilateral bronchial occlusion with a Swan-Ganz catheter. Pediatr Radiol. 2007;37(11):1130
Gaylord MS, Quissell BJ, Lair ME. High-frequency ventilation in the treatment of infants weighing less than 1,500 grams with pulmonary interstitial emphysema: a pilot study. Pediatrics. 1987;79(6):915.
Dördelmann M, Schirg E, Poets CF, Ure B, Glüer S, Bohnhorst B. Therapeutic lung puncture for diffuse unilateral pulmonary interstitial emphysema in preterm infants. Eur J Pediatr Surg. 2008;18(4):233-6.