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PULMONARY AIR LEAK SYNDROME

PULMONARY AIR LEAK SYNDROME. RT 256. AIR LEAKS:. Pathophysiology High transpulmonary pressures applied to the lungs Alveoli overdistend and rupture Air leaks into the interstitium Gas may remain local or spread Rupture the visceral pleura and/or pulmonary hila.

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PULMONARY AIR LEAK SYNDROME

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  1. PULMONARY AIR LEAK SYNDROME RT 256

  2. AIR LEAKS: Pathophysiology • High transpulmonary pressures applied to the lungs • Alveoli overdistend and rupture • Air leaks into the interstitium • Gas may remain local or spread • Rupture the visceral pleura and/or pulmonary hila

  3. - PULMONARY INTERSTITIAL EMPHYSEMA (PIE)- PNEUMOTHORAX- PNEUMOMEDIASTINUM- INTRAVASCULAR SYSTEMIC AIR EMBOLISM

  4. PULMONARY CONSEQUENCES OF AIR LEAK • Restriction from the trapped gas • Atelectasis • Inflammatory response at the site of rupture • Hypoxemia and ……..

  5. ETIOLOGY • High risk with: • Mechanical ventilation • Preterm infant • Trauma • Spontaneous manifestations may occur at any age but not very common in infant and pediatric patients

  6. PNEUMOTHORAX • Presence of air or gas in the pleural cavity • Can be life threatening • Occurs as: • Primary spontaneous • Secondary spontaneous • Traumatic • Iatrogenic • Simple or complicated (tension) • Severity of symptoms depends on extent of lung collapse

  7. PIE • Collection of gas outside the normal air passages • Rarely seen in the absence of mechanical ventilation or CPAP • Compresses adjacent lung tissue and vascular structures

  8. PNEUMOMEDIASTINUM • Spontaneous occurrence is a rare condition • Infrequently develops clinically significant complications • Tension pneumomediastinum will  cardiac output • Common symptoms: subcutaneous emphysema and neck/chest pain, cough, voice change • Associated / result of trauma, neonatal lung disease, mechanical ventilation, chest surgery

  9. MANAGEMENT • Diagnosis through transillumination of the neonate or CXR • PREVENTION! • Treatment is supportive: • Oxygenation • Bronchial hygiene • Hyperinflation • Chest tube placement • May require mechanical ventilation to support gas exchange (high frequency ventilation)

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