Pulmonary interstitial emphysema is a condition that has become a significant problem chiefly as a complication of mechanical ventilation of the newborn. In its severe forms, it may compromise ventilation and restrict pulmonary blood flow to the degree that it becomes a significant cause of mortality. When its occurrence is unilateral, or predominantly so, it becomes more amenable to therapy. A number of different approaches have been described, especially for milder forms of the disease, but none has proved entirely satisfactory. A surgical approach has been used in four patients with severe unilateral pulmonary interstitial emphysema complicating ventilator therapy for hyaline membrane disease. The technique was successful in three of the four infants. An illustrative case is described, as well as the selective criteria for application of the technique.
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