PULMONARY AIR LEAK SYNDROME RT 256. AIR LEAKS: Pathophysiology High transpulmonary pressures applied...
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Transcript of PULMONARY AIR LEAK SYNDROME RT 256. AIR LEAKS: Pathophysiology High transpulmonary pressures applied...
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PULMONARY AIR LEAK SYNDROMERT 256
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AIR LEAKS:
Pathophysiology High transpulmonary
pressures applied to the lungs
Alveoli overdistend and rupture
Air leaks into the interstitium Gas may remain
local or spread Rupture the visceral
pleura and/or pulmonary hila
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- PULMONARY INTERSTITIAL EMPHYSEMA (PIE)- PNEUMOTHORAX- PNEUMOMEDIASTINUM- INTRAVASCULAR SYSTEMIC AIR EMBOLISM
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PULMONARY CONSEQUENCES OF AIR LEAK
Restriction from the trapped gas Atelectasis Inflammatory response at the site of rupture Hypoxemia and ……..
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ETIOLOGY
High risk with: Mechanical ventilation Preterm infant
Trauma
Spontaneous manifestations may occur at any age but not very common in infant and pediatric patients
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PNEUMOTHORAX
Presence of air or gas in the pleural cavity Can be life threatening Occurs as:
Primary spontaneous Secondary spontaneous Traumatic Iatrogenic
Simple or complicated (tension) Severity of symptoms depends on extent of
lung collapse
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PIE
Collection of gas outside the normal air passages
Rarely seen in the absence of mechanical ventilation or CPAP
Compresses adjacent lung tissue and vascular structures
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PNEUMOMEDIASTINUM
Spontaneous occurrence is a rare condition Infrequently develops clinically significant
complications Tension pneumomediastinum will cardiac
output Common symptoms: subcutaneous
emphysema and neck/chest pain, cough, voice change
Associated / result of trauma, neonatal lung disease, mechanical ventilation, chest surgery
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MANAGEMENT
Diagnosis through transillumination of the neonate or CXR
PREVENTION! Treatment is supportive:
Oxygenation Bronchial hygiene Hyperinflation
Chest tube placement May require mechanical ventilation to
support gas exchange (high frequency ventilation)