Pneumothorax in a preterm infant monitored by electrical impedance tomography: a case report.

Electrical impedance tomography (EIT) is a noninvasive bedside tool for monitoring regional changes in ventilation. We report, for the first time, the EIT images of a ventilated preterm infant with a unilateral pneumothorax, showing a loss of regional ventilation in the affected lung during both high-frequency oscillation and spontaneous ventilation.

[Neonatal respiratory distress caused by primary ciliary dyskinesia]. / Neonatale respiratoire problemen door primaire ciliaire dyskinesie.

Two newborns, both boys, presented with unexplained respiratory distress. One developed recurrent pneumonias in the first neonatal week and was diagnosed with primary ciliary dyskinesia at the age of 2.5 years. The other had respiratory problems besides a situs inversus totalis and was diagnosed with primary ciliary dyskinesia in the neonatal period. Although 65-90% of children with primary ciliary dyskinesia present with neonatal respiratory distress, the disease is often diagnosed after a considerable delay. Primary ciliary dyskinesia should be considered in newborns with unexplained respiratory problems and in children with recurrent respiratory problems. The disease is diagnosed by taking a nasal brush biopsy of the cilia and examining it using electron microscopy or using phase contrast microscopy. Early diagnosis and adequate treatment may prevent further lung damage.

Congenital absence of the trachea.

UNLABELLED: Congenital absence of the trachea is a rare cause of severe neonatal respiratory distress. Experimental studies show that it is probably caused by disorders in a system of folds in the tracheo-oesophageal space rather than abnormalities of a tracheo-oesophageal septum. A literature review disclosed 82 cases of tracheal agenesis, which showed male predominance and an association with prematurity and polyhydramnios. In 90% of cases associated congenital malformations were present, most frequently affecting the cardiovascular or gastro-intestinal systems and the genito-urinary tract. Clinical signs of tracheal agenesis or atresia are respiratory insufficiency, often with severe respiratory distress, absence of audible crying and difficult or impossible endotracheal intubation. At present, curative repair and survival are impossible unless there is enough proximal or distal trachea to create a tracheostoma. Important ongoing research is aimed at tissue-engineered cartilage for surgical repair of tracheal defects. CONCLUSION: Tracheal agenesis, although very rare, can be recognised from a characteristic clinical pattern. Mostly associated congenital malformations are present. Research into tissue-engineering might lead to possibilities for definitive surgical repair of tracheal agenesis or atresia; however, until curative repair becomes possible, prolonged ventilation via the oesophageal tube does not seem to be worthwhile.