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KMID : 1130320080510111179
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Korean Journal of Pediatrics
2008 Volume.51 No. 11 p.1179 ~ p.1184
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Study of the risk factors for pulmonary interstitial emphysema related to mechanical ventilator care
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Kim Sang-Yeob
Lee Pil-Sang
Lee Sang-Geel
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Abstract
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Purpose: Pulmonary interstitial emphysema (PIE) primarily occurs in preterm infants suffering from respiratory distress syndrome (RDS) and kept under mechanical ventilator care. Therefore, this study aimed to examine various risk factors for PIE, to identify conditions that can decrease the possibility of PIE development.
Methods: PIE classification was conducted for 1 8 3 patients diagnosed to have RDS and receiving mechanical ventilator care with pulmonary surfactant between March 2 0 0 0 and February 2 0 0 7 . The characteristics of each patient were analyzed through retrospective examination of their medical histories.
Results: Among 1 8 3 patients, 1 7 had PIE; all factors, including birth weight, gestational age, RDS grade III or above, chorioamnionitis, and premature rupture of membranes, were statistically significant (P< 0 .0 5 ). The period of mechanical ventilator use was statistically significant, but the peak mean airway pressure and peak partial pressure of inspired oxygen were not. PIE mainly occurred on the right side or both sides rather than the left side and mostly developed within 7 2 h. The PIE group showed higher mortality rate than the control group, and the major cause of mortality was pneumothorax.
Conclusion: Risk factors for PIE in infants suffering from RDS and kept under mechanical ventilator care include low gestational age, low birth weight, chorioamnionitis, and premature rupture of membranes. If any risk factors are noted, the infant must be observed closely for at least 7 2 h after birth.
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KEYWORD
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Pulmonary interstitial emphysema, Respiratory distress syndrome, Pneumothorax, Chorioamnionitis
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