Which factors increase the risk of pulmonary interstitial emphysema (PIE)?

Updated: Jun 25, 2019
  • Author: Abhay J Bhatt, MD, MBBS; Chief Editor: Muhammad Aslam, MD  more...
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Risk factors for pulmonary interstitial emphysema (PIE) include the following:

  • Prematurity
  • Respiratory distress syndrome (RDS)
  • Meconium aspiration syndrome (MAS)
  • Amniotic fluid aspiration
  • Infection: Exposure to chorioamnionitis, neonatal sepsis, or pneumonia,
  • Low Apgar score or need for positive pressure ventilation (PPV) during resuscitation at birth
  • Use of high peak airway pressures on mechanical ventilation therapy in the first week of life
  • Incorrect positioning of the endotracheal tube in one bronchus
  • Antenatal exposure to magnesium sulfate [18] : More investigation is needed

Independent risk factors for PIE in preterm infants include higher oxygen requirements during resuscitation as well as greater need for surfactant and higher ventilatory pressures before confirmation of the diagnosis. [5, 19]

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