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A Short Note On The Air Leak Syndrome

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Introduction
Air Leak Syndrome is a term used to describe a collection of similar pathologies related to air being in pulmonary, pleural and interstitial spaces. The most common cause of air leak syndrome in neonates is inadequate mechanical ventilation of their delicate lungs. The incidence of air leaks in newborns is inversely related to the birth weight of the infants, especially in infants suffering from respiratory distress syndrome and meconium aspiration (Walsh, 2015). Chest tube drainage and/or needle aspiration are necessary in managing pneumopericardium with cardiac tamponade or tension pneumothorax.
To prevent air leak syndrome, gentle ventilation with low pressure, low tidal volume, low inspiratory time, high rate, and …show more content…

For pneumothorax, the incidence from 1990-2002 was 13% in babies weighing <1000 grams are at high risk the first day or two after birth. Babies with pulmonary hypoplasia, meconium aspiration syndrome, and respiratory distress syndrome are also at higher risk. Use of NIV/CPAP also increases the risk. An article in the Pediatrics journal cited three cases where children of various ages developed various air leaks from the use of high-flow nasal cannula (HHNC) therapy. The author cited the urgent need to conduct more studies on HHNC and that it should not be used for providing positive distending pressure. Set flows should not exceed the patient’s minute ventilation (Hegde, 2013).
Prevention
Sadly, it should be understood that most of pulmonary air leaks are iatrogenic. Healthcare workers should not be overly aggressive when doing CPR and using the bag mask. Infants’ lungs are fragile and cannot handle being over-ventilated. When using mechanical ventilation, use low pressures low tidal volumes and high respiratory rates. Risk of pneumothorax and pulmonary interstitial emphysema can be reduced by using surfactant.
Pathophysiology
Air leaks are a result of overdistention of the lungs and can cause uneven alveolar ventilation and air trapping. Increased pressures can rupture alveoli or other tissues, allowing air to escape into the interstitial spaces. This air can then travel through perivascular adventitia, causing pulmonary interstitial emphysema. If the air

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