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Treatment for Pulmonary Interstitial Emphysema (PIE)

Pulmonary interstitial emphysema (PIE) is when air gets trapped in the tissue outside the tubes and air sacs of the lungs. It affects newborn babies. PIE is fairly common in neonatal intensive care units. PIE usually affects low-weight infants who need a ventilator. This is a device 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.

Types of treatment

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.

Treatment is done to make sure your child gets enough oxygen. It also aims to prevent more air leaks. Treatment may include:

  • Laying your baby on the side with air leak, which helps move more air into the lung that is working well

  • Lowering ventilator pressure, if possible, to help prevent more air leaks

  • Using high-frequency oscillatory ventilation, which may lower pressure in the air sacs

  • Giving extra oxygen

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.

Possible complications of PIE

PIE can sometimes cause pneumothorax. This is air in the space between the outer lungs and the chest wall. This can make breathing problems worse. Your child may need ventilator support or a chest tube for a large pneumothorax.

Preventing PIE

Preventing preterm birth may help prevent PIE. You can decrease the chance of preterm birth by:

  • Not smoking during pregnancy

  • Not using alcohol during pregnancy

  • Getting prenatal care throughout your pregnancy

  • Seeking medical attention at the first signs of preterm labor

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