1/13. Pulmonary venous air embolism in hyaline membrane disease.A newborn infant with the respiratory distress syndrome in whom pulmonary venous air embolism (PVAE) developed as a complication of positive pressure therapy is reported. The underlying pathophysiology in this disorder is probably the development of alveolar-capillary fistulae secondary to unduly high intrabronchial pressures. An increased awareness by radiologists and clinicians of PVAE as a potential complication of aggressive respiratory therapy will result in more frequent recognition of this uncommon but lethal disorder.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/13. Systemic air embolism: a complication of ventilator therapy in hyaline membrane disease.Systemic air embolism in infants with hyaline membrane disease on positive pressure ventilation is a serious and frequently fatal complication. It is essential for both the paediatrician and radiologist to be aware of this disease entity. The incidence is increasing because of improved survival of very low birth weight infants and more aggressive therapy. We report two examples of systemic air embolism in infants.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
3/13. Effects of highly overdosed indomethacin in a preterm infant with symptomatic patent ductus arteriosus.We describe a preterm infant with severe idiopathic respiratory distress syndrome (iRDS, hyaline membrane disease) who needed artificial ventilation with high inspiratory pressure, high frequencies, 100% oxygen and developed a symptomatic patent ductus arteriosus (sPDA) in the course of the disease. The infant was given indomethacin to induce constriction of sPDA. Due to an error in drug dilution the patient received a 100-fold overdose of indomethacin. Compared to the normal study protocol side-effects such as renal failure were not observed probably due to sufficient fluid intake and good clinical condition prior to treatment and to the rapid and persistent ductal closure.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
4/13. Pulmonary pseudocysts in the newborn infant.Five neonates who developed a pulmonary pseudocyst are reported. All infants had clinical hyaline membrane disease and were treated with continuous distending airway pressure. The pseudocysts developed between 39 hours and 7 days of age. In all but one pulmonary interstitial emphysema preceded or occurred together with the development of the pseudocyst. All babies went on to complete clinical recovery without surgical intervention. Radiologic documentation of the spontaneous resolution of the pseudocyst was obtained in three infants and occurred over three days, five days, and three months, respectively.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
5/13. Increased hypoxemia in neonates secondary to the use of continuous positive airway pressure.Five neonates are presented who, while receiving continuous transpulmonary pressure, developed increased systemic arterial hypoxemia, which was relieved when this therapeutic modality was decreased or discontinued. Three of the five had chest radiographs consistent with hyaline membrane disease: the other two had atypical radiographs. None had evidence of air leaks. Levels of positive airway pressure utilized when the hypoxemia was noted ranged from 5 to 15 cm H2O. Calculated shunt fractions (Qs/Qt) improved from a mean of 73% to 37% when the continuous positive airway pressure was lowered. The site of shunting in these infants could have been in the lung or through anatomic extrapulmonary shunts. Improvement in total cardiac output may also have contributed to the improved oxygenation. This paradoxical effect of continuous transpulmonary pressure appears to be mediated through changes in the pulmonary vascular resistance brought about by the continuous transpulmonary pressure.- - - - - - - - - - ranking = 4.5keywords = pressure (Clic here for more details about this article) |
6/13. Pulmonary vascular air embolism in hyaline membrane disease.Pulmonary vascular air embolism is a rare, fatal complication of positive-pressure ventilation in hyaline membrane disease. Sudden deterioration of an infant on respiratory therapy should alert the clinician and radiologist to the possibility of this entity. A case history with typical radiographic findings is presented.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
7/13. Pulmonary interstitial emphysema requiring lobectomy. Complications of assisted ventilation.An infant with hyaline membrane disease treated with intermittent positive pressure ventilation developed pulmonary interstitial emphysema localised to one lobe after collapse of the affected lobe. The development of tension and further symptoms necessitated lobectomy, after which the infant became totally asymptomatic. microscopy of the resected lobe showed the unusual feature of giant cells lining the air-containing cysts. The presence of these multinucleate cells suggested the cysts may have represented greatly dilated lymphatic channels resulting from rupture of gases into the pulmonary lymphatics.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
8/13. Successful therapy of unilateral pulmonary emphysema: mechanical ventilation with extremely short inspiratory time.We describe a novel approach to the mechanical ventilation of two neonates with life-threatening unilateral pulmonary emphysema (UPE). Using a standard time-cycled, pressure-limited ventilator, we achieved resolution of UPE with shorter inspiratory times than previously reported effective in human newborns (0.10-0.15 sec). We elected this ventilatory strategy in order to direct tidal volume preferentially toward units of lung with relatively normal time constants, while avoiding inflation of longer time-constant emphysematous areas.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
9/13. Diagram for easy volume setting of an infant ventilator.A pressure-volume diagram with isocompliance lines allows quick, accurate volume setting of the piston-driven infant ventilator Bourns LS. A line parallel with the machine compliance line and an intercept on the ordinate equal to the tidal volume, serves as a guideline for initial volume setting and subsequent adaptation according to the patient's lung compliance. This diagram is particularly useful when the lung compliance is low; changes consistently during controlled ventilation.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
10/13. Relationship of pneumothorax to occurrence of intraventricular hemorrhage in the premature newborn.The relationship of pneumothorax to the occurrence of intraventricular hemorrhage (IVH) has been studied in the premature newborn. The major objective of the study was to determine whether the systemic hemodynamic changes that occur with pneumothorax are reflected in the cerebral circulation and whether these changes play a role in pathogenesis of IVH. blood flow velocity was measured in the anterior cerebral arteries by a transcutaneous Doppler technique in nine infants who developed pneumothorax in the first 3 days of life. At the time of pneumothorax there was a marked increase in flow velocity, especially during diastole, and, with resolution of pneumothorax, flow velocity returned to normal levels over the ensuing hours. The changes in flow velocity correlated closely with systemic hemodynamic changes that occurred with pneumothorax, ie, and increase in mean systemic blood pressure, especially diastolic pressure. IVH, documented by serial ultrasound scans, was observed shortly after pneumothorax in the nine infants. The data thus demonstrate a marked increase in flow velocity in the cerebral circulation at the time of pneumothorax. This increase is of importance in the genesis of IVH as is suggested further by the occurrence of IVH soon after the cerebral hemodynamic changes.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
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