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Year : 2015  |  Volume : 4  |  Issue : 2  |  Page : 115-118

Resolution of localized pulmonary interstitial emphysema in two neonates - Why does neurally adjusted ventilatory assist work?

1 Department of Paediatrics and Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
2 Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Lai King Hill Road, Kwai Chung, Hong Kong, China

Correspondence Address:
Dr. Shing Yan Robert Lee
Department of Paediatrics and Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital, 2 Lok Man Road, Chai Wan, Hong Kong
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2249-4847.154113

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Localized pulmonary interstitial emphysema (PIE) is a known complication of mechanical ventilation. Recently, we encounter two cases of localized PIE, which developed on the course of mechanical ventilation using high-frequency oscillatory ventilation, followed by conventional intermittent positive pressure ventilation. We then switched the ventilator mode to neurally adjusted ventilatory assist (NAVA). We observed that on switching to NAVA, there was a decrease in peak inspiratory pressure (PIP) in case 1 and case 2, and decrease in tidal volume in case 2. Localized PIE resolved in 6-9 days' time. Since high PIP and high tidal volume are risk factors for PIE, NAVA could lead to resolution of localized PIE by achieving lower PIP and lower, but optimal tidal volume. We suggest that NAVA is a treatment of choice in localized PIE.

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