PEDS/NEONATES: Air Leak Syndrome

volutrauma, barotrauma, pneumothorax, and subcutaneous emphysema are all examples of...

air leak syndrome

name 4 examples of air leak syndrome

-pneumothorax

-subcutaneous emphysema

-volutrauma

-barotrauma

alveolar or airway rupture with the dissection of air into the lung interstitium and then the pleura rupture allowing the air to escape into the pleural mediastinal, pericardial, and abdominal cavities or under the skin

air leak syndrome

name 3 causes of air leak syndrome

-lung-overdistention

-iatrogenic causes (i.e. needle puncture or intubation)

-Valsalva maneuver

name two predisposing factors of air leak syndrome

-lung disease/immaturity (RDS)

-positive pressure ventilation

abnormal location of air within the pulmonary interstitium and lymphatics

pulmonary interstitial emphysema (PIE)

results from rupture of over-distended alveoli following barotrauma in infants who have hyaline membrane disease [HMD-surfactant deficiency]; Almost always associated with mechanical ventilation or CPAP in the first few weeks of a RDS patient

pulmonary interstitial emphysema [PIE]

what is a common treatment for pulmonary interstitial emphysema (PIE)?

switch from conventional to high frequency ventilation

presence of air in the mediastinum; the patient may be asymptomatic or have variable respiratory distress; Sail sign on CXR

Pneumomediastinum

air present in the pericardial cavity surrounding the heart; patient may be asymptomatic or present muffled/distant heart sounds

pneumopericardium

collapsed lung; air leaks into the space between the lungs and chest wall

pneumothorax

sudden collapse of the lung that requires immediate treatment

tension pneumothorax

air under the skin caused by blunt traumas, gunshot wounds, or stabbing

subcutaneous emphysema