Serving all people by providing personalized health and wellness through exemplary care, education and research.
Explore health content from A to Z.
I need information about...
Pulmonary interstitial emphysema (PIE) is when air gets trapped in the tissue outside of tiny air sacs (alveoli) in the lungs. It affects newborn babies. PIE is fairly common in neonatal intensive care units (NICUs).
When you breathe, air travels in through your mouth and nose to your lungs. The air goes into the alveoli. This is where gases get exchanged. Here, the lungs deliver oxygen to the blood. And they release carbon dioxide, a waste product. The oxygen then travels through the blood to all the organs of your body.
Normally, air in the lungs stays in the alveoli. But in some cases, air can escape into the nearby tissue around the tiny sacs. This tissue is called the interstitium. This can happen if the wall of an air sac breaks open. If enough air leaks out, this can cause problems with breathing and blood flow.
PIE usually affects low-weight infants who need a device (ventilator) that helps with breathing. These infants often have a lung problem that is caused by preterm birth. PIE usually affects infants in the first few days of life. It may affect one or both lungs.
PIE is classified by how long it lasts. Acute PIE lasts for less than a week. If it lasts longer, it is called persistent PIE. PIE may also be called diffuse or localized. Diffuse means it occurs in multiple places in the lungs. Localized means it occurs in a single spot.
PIE most often happens in preterm infants, when their lungs don't make enough of a substance called surfactant. Surfactant allows alveoli to be more flexible and less likely to break open.
Being on a ventilator may cause PIE. During artificial ventilation, a ventilator applies air pressure to the air sacs of your child’s lungs. This helps your child breathe by opening closed-off lung sacs. But in some cases, this extra pressure can create a leak in an air sac.
Babies with a greater risk of PIE are those with the following conditions:
Signs of PIE usually appear within 4 days of birth. Mild PIE may have no signs. More severe PIE may cause signs of breathing difficulty, such as:
You may be asked about you and your child’s medical history. This may include information before, during, and after birth. Your child will have a physical exam. His or her heart and lungs may be checked. Blood tests may be done to look for signs of low levels of oxygen and high levels of carbon dioxide.
Your child may also have an imaging test, such as a chest X-ray or a chest CT scan. Leaked air will often appear on both of these imaging tests.
PIE is a serious condition. It can cause death if not properly treated. For this reason, treatment is done inside a neonatal intensive care unit (NICU).
Treatment is done to make sure your child gets enough oxygen. It also aims to prevent more air leaks. Treatment may include:
Your child’s vital signs and levels of oxygen in the blood are checked during the treatment. Your child may also need X-rays to check on the status of the air leaks as they heal.
In most cases, PIE gets better with these treatments, and the leaked air goes away.
If your child has a severe localized case of PIE, the medical team may collapse the lung with the air leak for a short time. This is so the air sac can heal. This is done by placing a breathing tube into the lung without the air leak. Or, air flow may be blocked for a short time to the lung with the air leak. Your child might need a breathing tube and ventilator support during this time.
In rare cases, a child might need to have part of a lung removed to treat PIE that does not go away.
Your child may also need treatment for other lung problems that may be causing the PIE.
Preventing preterm birth may help prevent PIE. You can decrease the chance of preterm birth by:
Tips to help you get the most from a visit to your child’s healthcare provider:
Copyright © 2017 Baylor Scott & White Health. All Rights Reserved. |
3500 Gaston Ave., Dallas, TX 75246-2017 | 1.800.4BAYLOR