Unilateral pulmonary emphysema. Noninvasive treatment concept in two premature babies

Background. Pulmonary interstitial emphysema is a serious complication of n eonatal respiratory distress syndrome carrying an increased risk of intrave ntricular haemorrhage and development of chronic lung disease of prematurit y. Management of unilateral PIE usually includes aggressive methods such as surgical removal of the affected lung tissue or selective intubation of th e contralateral bronchus. Case report. We report two cases of unilateral interstitial emphysema resol ving completely with non-invasive management consisting of strict lateral d ecubitus positioning of the affected lung in combination with antiinflammat ory therapy. Discussion. We feel that the management of unilateral interstitial emphysem a presented in these cases is minimally invasive yet effective. We could no t determine whether positional treatment alone would have been equally effe ctive. Although the optimal choice of treatment clearly depends on the cond ition of the individual patient, we suggest to consider this approach in ca ses of unilateral interstitial emphysema.