scholarly journals Selective Bronchial Occlusion for Treatment of a Bronchopleural Fistula in an Extremely Preterm Infant

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1208
Author(s):  
Giacomo Simeone Amelio ◽  
Mariarosa Colnaghi ◽  
Silvia Gulden ◽  
Genny Raffaeli ◽  
Valeria Cortesi ◽  
...  
Keyword(s):  
Preterm Infant ◽  
Distress Syndrome ◽  
Rescue Therapy ◽  
Bronchopleural Fistula ◽  
Hyaline Membrane Disease ◽  
Chest Drain ◽  
Air Leak ◽  
Radiographic Findings ◽  
Extremely Preterm ◽  
High Frequency Oscillatory

Neonatal pulmonary air leak commonly occurs as a complication of mechanical ventilation in infants with underlying hyaline membrane disease. They can commonly be managed conservatively or with the application of a chest drain, but some severe cases pose a significant challenge in finding an alternative therapeutic solution. Selective bronchial occlusion represents an unconventional rescue therapy for treating bronchopleural fistula resistant to the standard therapy. A 27-week gestation preterm infant ventilated for respiratory distress syndrome developed tension right-sided pneumothorax. Conventional modalities of treatment were tried and were unsuccessful. Intermittent selective bronchial occlusion with a Fogarty’s catheter and high-frequency oscillatory ventilation resulted in considerable improvement in the infant’s clinical condition and radiographic findings.

scholarly journals Air Leak in Neonatal Respiratory Distress Syndrome

1984 ◽  
Vol 12 (1) ◽  
pp. 41-45 ◽  
Author(s):  
P. D. Sly ◽  
J. H. Drew
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Hyaline Membrane Disease ◽  
Maternity Hospital ◽  
Assisted Ventilation ◽  
Air Leak ◽  
Mechanical Ventilators ◽  
Hyaline Membrane ◽  
Neonatal Respiratory Distress

A review of 9401 consecutive live births at the Mercy Maternity Hospital, Melbourne, was performed to determine the incidence of air leak in those with respiratory distress syndrome. Respiratory distress was detected in 552 (5.9%) infants and hyaline membrane disease was the most common cause occurring in 238 (2.5%) infants. Air leak developed in 22% of infants with respiratory distress, 8% had pulmonary interstitial emphysema alone, 14% had pneumomediastinum or pneumothorax and 7% had emphysema with pneumomediastinum or pneumothorax. Mortality increased from 12% in infants without air leak to 31% (p < 0.001) in infants with air leak. Ninety-five per cent of air leak developed in infants with hyaline membrane, and these were smaller, less mature and sicker than those without air leak. Eighty-seven per cent of air leak developed in infants treated with assisted ventilation and was commoner with mechanical ventilators with a more rapid rise in inspiratory pressure.

scholarly journals Utility of Endobronchial Valves in a Patient with Bronchopleural Fistula in the Setting of COVID-19 Infection: A Case Report and Brief Review

2021 ◽  
Vol 23 (4) ◽  
pp. 109-114
Author(s):  
Nazanin Sheikhan ◽  
◽  
Elizabeth Benge ◽  
Amanpreet Kaur ◽  
Jerome Hruska ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Case Report ◽  
Distress Syndrome ◽  
Bronchopleural Fistula ◽  
Invasive Mechanical Ventilation ◽  
Air Leak ◽  
Mechanically Ventilated ◽  
Growing Body ◽  
Endobronchial Valve

Patients with COVID-19 pneumonia frequently develop acute respiratory distress syndrome (ARDS), and in severe cases, require invasive mechanical ventilation. One complication that can develop in patients with ARDS who are mechanically ventilated is a bronchopleural fistula (BPF). Although rare, the frequency of BPF in patients with COVID-19 pneumonia is increasingly recognized. Here, we present a 48-year old man with BPF associated with COVID-19 pneumonia. Treatment with a commercial endobronchial valve (EBV) system resulted in reduced air leak allowing for tracheostomy placement. Our case adds to a growing body of evidence suggesting that the presence of COVID-19 pneumonia does not hinder the utility of EBV’s in the treatment of BPF’s.

scholarly journals Republication of “Ultrasonographic Appearance of Lung Sliding in a Patient With a Bronchopleural Fistula on a High-Frequency Oscillator Ventilator”

2020 ◽  
Vol 36 (4) ◽  
pp. 345-348
Author(s):  
David John Wallace ◽  
Penny Sappington ◽  
Samuel Tisherman ◽  
Michael Stone
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
High Frequency ◽  
Distress Syndrome ◽  
Bronchopleural Fistula ◽  
High Frequency Oscillatory Ventilation ◽  
High Frequency Oscillator ◽  
Frequency Oscillator ◽  
High Frequency Oscillatory ◽  
Lung Sliding ◽  
Ultrasonographic Appearance

The patient with a bronchopleural fistula and acute respiratory distress syndrome can present a therapeutic challenge for the treating clinician. In this case, the authors describe the use of bedside thoracic sonography to show real-time improvement in a pneumothorax after initiation of high-frequency oscillatory ventilation. Sonography may have a role in the evaluation of ventilator strategies in the future, although validation of this application is still needed.

scholarly journals Non-invasive High-Frequency Oscillatory Ventilation as Initial Respiratory Support for Preterm Infants With Respiratory Distress Syndrome

2022 ◽  
Vol 9 ◽  
Author(s):  
Shu-Hua Lai ◽  
Ying-Ling Xie ◽  
Zhi-Qin Chen ◽  
Rong Chen ◽  
Wen-Hong Cai ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Distress Syndrome ◽  
Length Of Hospital Stay ◽  
Supplemental Oxygen ◽  
Respiratory Support ◽  
Air Leak ◽  
Non Invasive ◽  
Air Leak Syndrome ◽  
Respiratory Outcomes ◽  
High Frequency Oscillatory

Objectives: The aim of this study was to investigate the safety and feasibility of nHFOV as initial respiratory support in preterm infants with RDS.Methods: This study retrospectively analyzed the clinical data of 244 premature infants with RDS who were treated in our hospital from January 2016 to January 2019 and divided into the nHFOV group (n = 115) and the BiPAP group (n = 129) based on the initial respiratory support method.Results: Respiratory outcomes showed that the rate of NIV failure during the first 72 hours of life in the nHFOV group was significantly lower than that in the BiPAP group. The time of NIV in the nHFOV group was significantly shorter than that in the BiPAP group. The time of supplemental oxygen in the nHFOV group was significantly shorter than that in the BiPAP group. The incidence of air leakage syndrome in the nHFOV group was significantly lower than that in the BiPAP group, and the length of hospital stay of the nHFOV group was also significantly shorter than that in the BiPAP group. Although the rate of infants diagnosed with BPD was similar between the two groups, the rate of severe BPD in the nHFOV group was significantly lower than that in the BiPAP group.Conclusion: This study showed that nHFOV as initial respiratory support for preterm infants with RDS was feasible and safe compared to BiPAP. Furthermore, nHFOV can reduce the need for IMV and reduce the incidence of severe BPD and air leak syndrome.

Nasal High-Frequency Oscillatory Ventilation in Preterm Infants with Moderate Respiratory Distress Syndrome: A Multicenter Randomized Clinical Trial

Neonatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Xingwang Zhu ◽  
Zhichun Feng ◽  
Chengjun Liu ◽  
Liping Shi ◽  
Yuan Shi ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress Syndrome ◽  
Preterm Infants ◽  
High Frequency ◽  
Primary Outcome ◽  
Distress Syndrome ◽  
Invasive Mechanical Ventilation ◽  
Risk Difference ◽  
High Frequency Oscillatory Ventilation ◽  
High Frequency Oscillatory

<b><i>Objective:</i></b> To determine whether nasal high-frequency oscillatory ventilation (NHFOV) as a primary mode of respiratory support as compared with nasal continuous airway pressure (NCPAP) will reduce the need for invasive mechanical ventilation in preterm infants (26<sup>0/7</sup>–33<sup>6/7</sup> weeks of gestational age [GA]) with respiratory distress syndrome (RDS). <b><i>Methods:</i></b> This multicenter randomized controlled trial was conducted in 18 tertiary neonatal intensive care units in China. A total of 302 preterm infants born at a GA of 26<sup>0/7</sup>–33<sup>6/7</sup> weeks with a diagnosis of RDS were randomly assigned to either the NCPAP (<i>n</i> = 150) or the NHFOV (<i>n</i> = 152) group. The primary outcome was the need for invasive mechanical ventilation during the first 7 days after birth. <b><i>Results:</i></b> Treatment failure occurred in 15 of 152 infants (9.9%) in the ­NHFOV group and in 26 of 150 infants (17.3%) in the NCPAP group (95% CI of risk difference: −15.2 to 0.4, <i>p =</i> 0.06). In the subgroup analysis, NHFOV resulted in a significantly lower rate of treatment failure than did NCPAP in the strata of 26<sup>+0/7</sup>–29<sup>+6/7</sup>weeks of GA (11.9 vs. 32.4%, 95% CI of risk difference: −39.3 to −1.7, <i>p =</i> 0.03) and birth weight &#x3c;1,500 g (10.4 vs. 29.6%, 95% CI of risk difference: −33.8 to −4.6, <i>p =</i> 0.01). The rate of thick secretions causing an airway obstruction was higher in the NHFOV group than in the NCPAP group (13.8 vs. 5.3%, 95% CI of risk difference: 1.9–15.1, <i>p =</i> 0.01). No significant differences in other secondary outcomes were found between the NHFOV and NCPAP groups. <b><i>Conclusions:</i></b> NHFOV was not superior to NCPAP with regard to the primary outcome when applied as the primary respiratory support for RDS in infants between 26<sup>+0/7</sup> and 33<sup>+6/7</sup> weeks of GA. In the subgroup analysis, NHFOV seemed to improve effectiveness than NCPAP in preterm infants &#x3c;30 weeks of GA.

scholarly journals Relationship Between Incidence of Hyaline Membrane Disease and Maternal Hypertension During Pregnancy

2017 ◽  
Vol 38 (3-4) ◽  
pp. 47
Author(s):  
Lasmida Nazir Nuriman ◽  
Dadang Sjarif Hidajat
Keyword(s):  
Distress Syndrome ◽  
Hyaline Membrane Disease ◽  
Cross Sectional Study ◽  
Type I ◽  
Cross Sectional ◽  
Hypertension In Pregnancy ◽  
Hyaline Membrane ◽  
Neonatal Respiratory Distress ◽  
Maternal Hypertension ◽  
The Relationship

There have been controversies over the eiTect of hypertension in pregnancy on the incidence of type I neonatal respiratory distress syndrome or hyaline membrane disease (HMD). We investigated the relationship between the incidence of HMD and maternal hypertension during pregnancy in 91 infants at 34 weeks gestation or less. This retrospective cross sectional study included all live born babies between May 1, 1994 and April 30, 1995 at Dr. Hasan Sadikin General Hospital, Bandung. Maternal hypertension during pregnancy was diagnosed in 38 mothers of91 infants studied. The incidence of HMD (5%) in the maternal hypertension during pregnancy group was significantly lower than the 62% in the normotensive group (p<0.01). There was a negative correlation between the occurence of HMD and hypertension during pregnancy. We conclude that the risk of developing HMD in infants born to hypertensive mothers is significantly lower than those born to normotensive mothers.

scholarly journals High-Frequency Oscillatory Ventilation Combined with Volume Guarantee in a Neonatal Animal Model of Respiratory Distress Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Manuel Sánchez Luna ◽  
Martín Santos González ◽  
Francisco Tendillo Cortijo
Keyword(s):  
Animal Model ◽  
High Frequency ◽  
Distress Syndrome ◽  
Lung Surfactant ◽  
High Frequency Oscillatory Ventilation ◽  
Constant Frequency ◽  
Oscillatory Ventilation ◽  
Before And After ◽  
Lung Condition ◽  
High Frequency Oscillatory

Objective. To assess volume guarantee (VG) ventilation combined with high-frequency oscillatory ventilation (HFOV) strategy on PaCO2regulation in an experimental model of neonatal distress syndrome.Methods. Six 2-day-old piglets weighing  kg were used for this interventional experimental study. Animals were ventilated during physiologic lung conditions and after depletion of lung surfactant by bronchoalveolar lavage (BAL). The effect of HFOV combined with VG on PaCO2was evaluated at different high-frequency expired tidal volume (VThf) at constant frequency () and mean airway pressure (mPaw). Fluctuations of the pressure (ΔPhf) around the mPaw and PaCO2were analyzed before and after lung surfactant depletion.Results. PaCO2levels were inversely proportional to VThf. In the physiological lung condition, an increase in VThf caused a significant decrease in PaCO2and an increase in ΔPhf. After BAL, PaCO2did not change as compared with pre-BAL situation as the VThf remained constant by the ventilator.Conclusions. In this animal model, using HFOV combined with VG, changes in the VThf settings induced significant modifications in PaCO2. After changing the lung condition by depletion of surfactant, PaCO2remained unchanged, as the VThf setting was maintained constant by modifications in the ΔPhf done by the ventilator.

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