Chest xray demonstrating a pneumatocele in the right upper lobe
Wednesday, March 24, 2010
The Pneumatocele
I'm taking care of a former premie right now who has all of us a bit puzzled by her absolute refusal to part with her ventilator. Despite requiring very little support while on the ventilator, as soon as her endotracheal tube is removed she "tries to run for the bright light". She had a severe pneumonia several weeks ago with MRSA (a kind of staphylococcus which is sometimes a problem in hospitals and can be difficult to treat). With treatment and time, her lungs have improved dramatically, however, she developed a cystic cavity in the right upper lobe of her lung. We call this a pneumatocele, and it sometimes occurs with this type of pneumonia. In consultation with the pediatric pulmonologist, our current hypothesis is that while the ET tube keeps the trachea open, upon its removal, the pneumatocele impinges upon it and causes it to collapse. So the plan is to look down the trachea with a flexible scope to look for any obstruction. If there does appear to be some impingement, a surgical procedure may be necessary.
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If surgery is required, who does the surgery? Are there specialized surgeons for neonates?
ReplyDeleteHi Emily, Thanks for reading! If surgery is required (which it wasn't for this particular problem, more follow up on that later) it can be done by a pediatric surgeon. Some institutions have cardiothoracic surgeons who would be the ideal person, but a pediatric surgeon is very qualified for this type of procedure as well.
ReplyDeleteThanks again for the comment.