What is pulmonary interstitial emphysema (PIE)?

Updated: Feb 28, 2019
  • Author: Beverly P Wood, MD, MSEd, PhD; Chief Editor: John Karani, MBBS, FRCR  more...
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Pulmonary interstitial emphysema (PIE) is an iatrogenic pulmonary condition of the premature infant with immature lungs. PIE occurs almost exclusively in association with respiratory distress syndrome and mechanical ventilation. [1]  Independent risk factors for mechanical ventilation-caused pulmonary interstitial emphysema are higher oxygen during resuscitation and a higher need for surfactant and ventilatory pressures before diagnosis. [2]

The ventilatory pressure that is used to keep the alveolar ducts open also may cause the alveolar duct to rupture (usually at the junction of the bronchiole and alveolar duct); this in turn leads to the escape of air into the pulmonary interstitium, lymphatics, and venous circulation. [3, 4, 5]

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