scholarly journals Severe Pulmonary Air Leak Complicating Neonatal Resuscitation

2020 ◽  
Author(s):  
. Supriya ◽  
Perumalla Bhavani Deepthi ◽  
S Giridhar
Keyword(s):  
Supportive Care ◽  
Respiratory Distress ◽  
Neonatal Resuscitation ◽  
Respiratory Morbidity ◽  
Positive Pressure ◽  
Chest Drain ◽  
Air Leak ◽  
Severe Respiratory Distress ◽  
Air Leaks ◽  
Interscapular Region

Air leaks are an important respiratory morbidity in neonates and can result from positive pressure breaths administered at birth. The presentations can vary from being asymptomatic to severe respiratory distress and hypoxaemia. This report is about a term boy who presented with respiratory distress immediately after birth, following resuscitation. He also had a diffuse swelling in the nape of the neck and interscapular region with crepitus on palpation. Serial chest radiographs initially revealed a pneumomediastinum and a subcutaneous emphysema, followed later by a right-sided pneumothorax. After chest drain insertion and supportive care, the air leaks resolved, with no residual complications. Severe air leaks with multi-site air tracking can rarely complicate positive pressure administration at birth, requiring timely intervention to optimise outcomes.

Acute exogenous lipoid pneumonia presenting as spontaneous air leak following accidental baby oil aspiration

2019 ◽  
Vol 50 (2) ◽  
pp. 149-152
Author(s):  
Vijai Williams ◽  
Gopalakrishnan Ezhumalai ◽  
Ajay Thakur ◽  
Arun Bansal ◽  
Muralidharan Jayashree
Keyword(s):  
Respiratory Distress ◽  
Indian Subcontinent ◽  
Air Leak ◽  
Severe Respiratory Distress ◽  
Lipoid Pneumonia ◽  
Air Leaks ◽  
Long Term Follow Up ◽  
Significant Chemical

Exogenous lipoid pneumonia (ELP) is an uncommon cause of respiratory distress. The practice of oil massage and oil instillation into the nostrils is common in the Indian subcontinent. Accidental aspiration of baby oil may lead to significant chemical pneumonitis. This presentation may vary from subtle to severe respiratory distress requiring intensive care management. Spontaneous air leaks are rare in acute ELP. We successfully managed a six-month-old girl presenting with mineral oil-induced ELP and air leaks. However, these children require long-term follow-up, as a small proportion may evolve into chronic lung disease.

Neonatal Resuscitation

2021 ◽  
pp. 177-182
Author(s):  
Sarah Nizamuddin
Keyword(s):  
Heart Rate ◽  
Respiratory Distress ◽  
Positive Pressure Ventilation ◽  
Neonatal Resuscitation ◽  
Positive Pressure ◽  
Respiratory Effort ◽  
Chest Compressions ◽  
Adequate Ventilation

After birth, the neonate must be immediately examined to evaluate the need for further resuscitation. Presence of an adequate respiratory effort and heart rate is vital, in addition to adequate tone and temperature. Warm, dry, and closely monitor the infant immediately after birth. Give positive pressure ventilation if there are any signs of respiratory distress or bradycardia. Low heart rate in a neonate is almost always due to hypoxia, so establish adequate ventilation as soon as possible in these cases. In cases of continued bradycardia, chest compressions and medication (epinephrine) may be necessary. Following resuscitation, transfer the neonate to an appropriate unit for continued monitoring.

scholarly journals Face Mask Ventilation in Edentulous Patients

2010 ◽  
Vol 112 (5) ◽  
pp. 1190-1193 ◽  
Author(s):  
Stéphane X. Racine ◽  
Audrey Solis ◽  
Nora Ait Hamou ◽  
Philippe Letoumelin ◽  
David L. Hepner ◽  
...  
Keyword(s):  
Standard Method ◽  
Patient Characteristics ◽  
Face Mask ◽  
Positive Pressure ◽  
Mask Ventilation ◽  
Air Leak ◽  
Lower Lip ◽  
Air Leaks ◽  
Edentulous Patients ◽  
Ventilation Method

Background In edentulous patients, it may be difficult to perform face mask ventilation because of inadequate seal with air leaks. Our aim was to ascertain whether the "lower lip" face mask placement, as a new face mask ventilation method, is more effective at reducing air leaks than the standard face mask placement. Methods Forty-nine edentulous patients with inadequate seal and air leak during two-hand positive-pressure ventilation using the ventilator circle system were prospectively evaluated. In the presence of air leaks, defined as a difference of at least 33% between inspired and expired tidal volumes, the mask was placed in a lower lip position by repositioning the caudal end of the mask above the lower lip while maintaining the head in extension. The results are expressed as mean +/- SD or median (25th-75th percentiles). Results Patient characteristics included age (71 +/- 11 yr) and body mass index (24 +/- 4 kg/m2). By using the standard method, the median inspired and expired tidal volumes were 450 ml (400-500 ml) and 0 ml (0-50 ml), respectively, and the median air leak was 400 ml (365-485 ml). After placing the mask in the lower lip position, the median expired tidal volume increased to 400 ml (380-490), and the median air leak decreased to 10 ml (0-20 ml) (P < 0.001 vs. standard method). The lower lip face mask placement with two hands reduced the air leak by 95% (80-100%). Conclusions In edentulous patients with inadequate face mask ventilation, the lower lip face mask placement with two hands markedly reduced the air leak and improved ventilation.

Air leak with COVID-19 – A meta-summary

2021 ◽  
pp. 021849232110311
Author(s):  
Prashant Nasa ◽  
Deven Juneja ◽  
Ravi Jain
Keyword(s):  
Respiratory Disease ◽  
Positive Pressure Ventilation ◽  
Case Reports ◽  
Final Analysis ◽  
Respiratory Support ◽  
Positive Pressure ◽  
Air Leak ◽  
Air Leaks ◽  
Air Leak Syndrome ◽  
The Individual

Introduction There are various reports of air leaks with coronavirus disease 2019 (COVID-19). We undertook a systematic review of all published case reports and series to analyse the types of air leaks in COVID-19 and their outcomes. Methods The literature search from PubMed, Science Direct, and Google Scholar databases was performed from the start of the pandemic till 31 March 2021. The inclusion criteria were case reports or series on (1) laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, (2) with the individual patient details, and (3) reported diagnosis of one or more air leak syndrome (pneumothorax, subcutaneous emphysema, pneumomediastinum, pneumoperitoneum, pneumopericardium). Results A total of 105 studies with 188 patients were included in the final analysis. The median age was 56.02 (SD 15.53) years, 80% males, 11% had previous respiratory disease, and 8% were smokers. Severe or critical COVID-19 was present in 50.6% of the patients. Pneumothorax (68%) was the most common type of air leak. Most patients (56.7%) required intervention with lower mortality (29.1% vs. 44.1%, p = 0.07) and intercostal drain (95.9%) was the preferred interventional management. More than half of the patients developed air leak on spontaneous breathing. The mortality was significantly higher in patients who developed air leak with positive pressure ventilation (49%, p < 0.001) and required escalation of respiratory support (39%, p = 0.006). Conclusion Air leak in COVID-19 can occur spontaneously without positive pressure ventilation, higher transpulmonary pressures, and other risk factors like previous respiratory disease or smoking. The mortality is significantly higher if associated with positive pressure ventilation and escalation of respiratory support.

Adult Respiratory Distress Syndrome in Full-Term Newborns

PEDIATRICS ◽  
1989 ◽  
Vol 83 (6) ◽  
pp. 971-976
Author(s):  
Roger G. Faix ◽  
Rose M. Viscardi ◽  
Michael A. DiPietro ◽  
Joanne J. Nicks
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Adult Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Prolonged Mechanical Ventilation ◽  
Full Term ◽  
Positive Pressure ◽  
Positive End Expiratory Pressure ◽  
Severe Respiratory Distress ◽  
Continuous Positive Pressure

Since 1984, 11 newborns with severe respiratory distress have been treated whose clinical characteristics appear distinctive. Characteristics of these neonates were as follows: (1) they were full term by obstetric and neonatal criteria, (2) they had diffuse bilateral alveolar opacification on chest radiographs during the acute illness, (3) each had an acute perinatal triggering insult, (4) the neonates required continuous positive pressure ventilation for at least 48 hours with Fio2 &gt; 0.50 for at least 12 hours, (5) they needed positive end-expiratory pressure of 6 cm of H2O or greater within three days of the triggering event, (6) there were no other known causes of these clinical conditions. Ten (91%) neonates had evidence of other organ dysfunction in addition to the lungs. Trials of hyperventilation in nine and tolazoline in five failed to improve oxygenation. Ten infants who underwent trials of increased positive end-expiratory pressure ≥6 cm of H2O without other concurrent changes in ventilator settings responded with prompt increases in PaO2 (median increase 84 mm Hg, range 22 to 196 mm Hg). All 11 babies survived but required prolonged mechanical ventilation and supplemental oxygen. We suggest that adult respiratory distress syndrome can and does occur in newborns. A trial of positive end-expiratory pressure ≥6 cm of H2O should be considered in full-term infants with severe respiratory distress in whom other causes can be excluded.

A homozygous variant in ABCA3 is associated with severe respiratory distress and early neonatal death

2021 ◽  
Author(s):  
Montaha Al‐Iede ◽  
Mariam Khanfar ◽  
Luma Srour ◽  
Raja Rabah ◽  
Mousa Al‐Abbadi ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Neonatal Death ◽  
Early Neonatal Death ◽  
Severe Respiratory Distress ◽  
Homozygous Variant
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