Korean J Pediatr.  2008 Nov;51(11):1179-1184. 10.3345/kjp.2008.51.11.1179.

Study of the risk factors for pulmonary interstitial emphysema related to mechanical ventilator care

• Kim SY
• Lee PS
• Lee SG

• KMID: 2280241
• DOI: http://doi.org/10.3345/kjp.2008.51.11.1179

Abstract

PURPOSE: Pulmonary interstitial emphysema (PIE) primarily occurs in preterm infants suffering from respiratory distress syndrome (RDS) and kept under mechanical ventilator care. Therefore, this study aimed to examine various risk factors for PIE, to identify conditions that can decrease the possibility of PIE development.
METHODS
PIE classification was conducted for 183 patients diagnosed to have RDS and receiving mechanical ventilator care with pulmonary surfactant between March 2000 and February 2007. The characteristics of each patient were analyzed through retrospective examination of their medical histories.
RESULTS
Among 183 patients, 17 had PIE; all factors, including birth weight, gestational age, RDS grade III or above, chorioamnionitis, and premature rupture of membranes, were statistically significant (P<0.05). The period of mechanical ventilator use was statistically significant, but the peak mean airway pressure and peak partial pressure of inspired oxygen were not. PIE mainly occurred on the right side or both sides rather than the left side and mostly developed within 72 h. The PIE group showed higher mortality rate than the control group, and the major cause of mortality was pneumothorax.
CONCLUSION
Risk factors for PIE in infants suffering from RDS and kept under mechanical ventilator care include low gestational age, low birth weight, chorioamnionitis, and premature rupture of membranes. If any risk factors are noted, the infant must be observed closely for at least 72 h after birth.

Keyword

Pulmonary interstitial emphysema; Respiratory distress syndrome; Pneumothorax; Chorioamnionitis

MeSH Terms

Birth Weight
Chorioamnionitis
Emphysema
Female
Gestational Age
Humans
Infant
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Membranes
Oxygen
Partial Pressure
Parturition
Pneumothorax
Pregnancy
Pulmonary Surfactants
Retrospective Studies
Risk Factors
Rupture
Stress, Psychological
Ventilators, Mechanical
Oxygen
Pulmonary Surfactants