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March 1977

Selective Bronchial Intubation in the Management of Unilateral Pulmonary Interstitial Emphysema

Author Affiliations

Department of Pediatrics Oklahoma Childrens Memorial Hospital 940 NE 13th St Oklahoma City, OK 73190

Am J Dis Child. 1977;131(3):365. doi:10.1001/archpedi.1977.02120160119020

Pulmonary interstitial emphysema has been well demonstrated as a complication of the neonate with respiratory distress. On occasion, the disorder may be unilateral and massive, presenting a picture similar to congenital emphysema. Therapy has been unsatisfactory.

We wish to report an infant with pulmonary interstitial emphysema who was successfully treated by selective intubation of a major bronchus.

Report of a Case.—A 1,560-gm female infant was delivered by a 16-year-old primigravida at about 32 weeks' gestation. Respiratory distress developed in the infant during the first 24 hours. By the third hospital day, she required intubation and mechanical ventilation with a respirator. Except for an unsuccessful attempt at weaning from 100% oxygen during the second week of life, she required mechanical ventilation and maximum oxygen concentrations for more than 30 days. Furthermore, in spite of attempts to reduce respirator pressures, progressive pulmonary interstitial emphysema with hyperinflation of the left lung, right

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