title: Percutaneous evacuation of diffuse pulmonary interstitial emphysema by lung puncture in a baby with extremely low birth weight: a case report.
abstract: BACKGROUND
  Pulmonary interstitial emphysema is a serious complication of mechanical ventilation and can become life-threatening if progression occurs. Therapeutic lung puncture is a treatment option for severe pulmonary interstitial emphysema but has a limited use in babies with extremely low birth weight. We present a case of pulmonary interstitial emphysema in a Japanese baby (1-day-old) boy with extremely low birth weight. The emphysema was successfully decompressed by therapeutic lung puncture performed with a trocar catheter.
  
  
  METHODS
  The baby was born with a weight of 420g, which, to the best of our knowledge, is the lowest reported birth weight among babies with pulmonary interstitial emphysema. A chest X-ray on postnatal day 2 revealed pulmonary interstitial emphysema, which gradually progressed to diffuse pseudocystic changes. His condition became life-threatening despite the use of high-frequency oscillatory ventilation and lateral decubitus positioning. We evacuated the pulmonary interstitial emphysema by lung puncture with a trocar catheter to avoid respiratory and cardiovascular collapse. This resulted in adequate evacuation of the emphysema and a dramatic improvement in his clinical condition.
  
  
  CONCLUSIONS
  Therapeutic lung puncture performed with a trocar catheter is beneficial in babies with extremely low birth weight and diffuse pulmonary interstitial emphysema. This treatment option may be broadly applicable, especially in an emergency situation.
authors.affiliation: Department of Pediatrics, Fukushima Medical University, 1st Hikarigaoka, Fukushima, 960-1295, Japan. nabe5658@fmu.ac.jp.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Watanabe
authors.forename: Nobuo
authors.initials: N
authors.lastname: Momoi
authors.forename: Maki
authors.initials: M
authors.lastname: Sato
authors.forename: Hayato
authors.initials: H
authors.lastname: Go
authors.forename: Takashi
authors.initials: T
authors.lastname: Imamura
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kaneko
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Hosoya