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首页> 外文期刊>Radiologia Brasileira >Bilateral pulmonary interstitial emphysema in a preterm infant on continuous positive airway pressure: clinical and radiological correlation
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Bilateral pulmonary interstitial emphysema in a preterm infant on continuous positive airway pressure: clinical and radiological correlation

机译：持续气道正压的早产儿双侧肺间质性肺气肿：临床和影像学相关性

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Here, we report the case of a newborn male, the product of a diamniotic twin pregnancy and a vaginal birth at 27 weeks and 2 days of gestational age, who had a birth weight of 920 g, with 1-, 5-, and 10-min Apgar scores of 3, 7, and 9, respectively. The mother did not receive corticosteroids, and there were no signs of infection in the amniotic fluid at the time of delivery. At birth, the neonate presented bradycardia and received mask ventilation with a positive pressure of 20 cmH2O. After 50 s, the heart rate returned to baseline, the infant then being transferred to the neo natal intensive care unit (NICU). At NICU admission, the infant was placed on continuous positive airway pressure (CPAP) at 5 cmH2O with a fraction of inspired oxygen of 50%. On physical examination, lung auscultation revealed normal breath sounds and few rhonchi. The neonate also showed moderate intercostal retractions and respiratory rate of 60 breaths/min. As can be seen in Figure 1A, the chest X-ray findings were consistent with respiratory distress syndrome (RDS). After five hours of life, lung aus-cultation showed a decrease in air intake and there were mod-erate intercostal retractions. At eight hours of life, he evolvedto apnea, respiratory difficulty, grunting, and subdiaphragmaticretractions. A new chest X-ray showed diffuse, bilateral cystic im-ages consistent with pulmonary interstitial emphysema (PIE), asdepicted in Figure 1B. Endotracheal intubation was performed,the neonate subsequently evolving to bradycardia and cyanosis ofthe extremities. Adrenaline and calcium gluconate were admin-istered. Cardiopulmonary resuscitation was performed, withoutsuccess, for 20 min, and the infant died at nine hours of life.
机译：在此，我们报告了一个新生儿，即双胎双胎妊娠和胎​​龄为27周和2天时阴道分娩的产物，该新生儿的出生体重为920 g，分别为1、5和10 -最低的Apgar分数分别为3、7和9。母亲没有接受皮质类固醇激素，并且在分娩时没有羊水感染的迹象。新生儿出生时出现心动过缓并接受面罩通气，正压为20 cmH2O。 50 s后，心率恢复到基线，然后将婴儿转移到新生儿重症监护室（NICU）。在新生儿重症监护病房（NICU）入院时，将婴儿置于5 cmH2O的持续气道正压通气（CPAP），吸氧分数为50％。体格检查显示，肺部听诊显示呼吸音正常，少见涡卷。新生儿还表现出中度肋间回缩，呼吸频率为60次呼吸/分钟。如图1A所示，胸部X光检查结果与呼吸窘迫综合征（RDS）一致。在生命的五个小时后，肺部听诊显示出空气摄入量减少，并且肋间有一定程度的回缩。在生命的八个小时中，他演变为呼吸暂停，呼吸困难，咕gr声和dia肌下陷。新的胸部X线照片显示弥漫性双侧囊性图像，与肺间质性肺气肿（PIE）一致，如图1B所示。进行气管插管，新生儿随后发展为心动过缓和四肢发。服用肾上腺素和葡萄糖酸钙。未成功进行心肺复苏20分钟，婴儿在生命的9小时内死亡。

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