title: Steroid-induced resolution of refractory pulmonary interstitial emphysema.
abstract: Pulmonary interstitial emphysema (PIE) is a familiar complication of mechanical ventilation in premature infants. Its most severe form, marked by life-threatening respiratory and cardiovascular compromise, is a particularly vexing problem in neonatology. Treatment modalities rely on decubitus positioning and reduction of mean airway pressure, but refractory PIE is unresponsive to these maneuvers. Other options such as selective unilateral bronchial intubation, balloon catheter bronchial occlusion, selective lung volume reduction, and mechanical decompression each have clear limitations. In a patient with refractory, life-threatening PIE too unstable for other therapeutic modalities, we describe success with steroid therapy at a familiar dosing regimen.
authors.affiliation: a Division of Critical Care, Department of Pediatrics , University of Nebraska Medical Center , Omaha , NE , USA and.
authors.forename: Sidharth
authors.initials: S
authors.lastname: Mahapatra
authors.affiliation: b Division of Neonatology, Department of Pediatrics , Oregon Health and Science University , Portland , OR , USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Scottoline
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D045422:Continuous Positive Airway Pressure / Q000009:adverse effects*; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage*; D052577:Infant, Extremely Low Birth Weight; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D011656:Pulmonary Emphysema / Q000150:complications / Q000188:drug therapy*; D011859:Radiography; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000893:Anti-Inflammatory Agents; D006854:Hydrocortisone
keywords: Hydrocortisone; pneumothorax; pulmonary interstitial emphysema; respiratory distress syndrome; steroids