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Pulmonary Interstitial
Emphysema
Pulmonary interstitial emphysema
(PIE) occurs when abnormal collections of air develop within
the lungs. The small airways and terminal sac rupture but
instead of the rupturing into the chest cavity to produce
a pneumothorax the small amounts of air are trapped within
the lung itself air. PIE is more frequent in premature infants
who require mechanical ventilation for severe lung disease
such as respiratory
distress syndrome.
PIE may also lead to air
leaks and tension pneumothorax,
once PIE is diagnosed, intensive respiratory management is
required because the trapped air makes the lung very stiff
and greatly inhibits gas exchange.
PIE occurs less frequently
as premature babies are now treated with exogenous surfactant,
which helps to keep the lungs open. Babies with PIE often
require long-term ventilator therapy and many develop bronchopulmonary
dysplasia (BPD).
Treatment is difficult
and may include
- High-frequency ventilation
- Selective Bronchial intubation
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