ABSTRACT
Pulmonary air leaks include urgent life-threatening neonatal emergencies like pulmonary interstitial emphysema (PIE), pneumomediastinum, pneumothorax (PT), or pneumopericardium. The incidence of pulmonary air leaks in the neonates has increased in recent years, possibly because an increasing number of sick infants with respiratory distress on assisted ventilation are now surviving to develop this complication. PIE is predominantly seen in preterm infants with respiratory distress syndrome (RDS) who are on assisted ventilation. Pneumomediastinum develops when interstitial air in PIE migrates to the mediastinum. Ultrasound can be used to diagnose pneumomediastinum. Pneumothorax in the newborn predominantly occurs in patients with hyaline membrane disease, meconium aspiration syndrome, pulmonary hypoplasia, and infants requiring vigorous resuscitation at birth. Pneumopericardium is the least frequent pulmonary air leak. Neonatal pneumopericardium has also been reported during nasal continuous positive airway pressure (CPAP) ventilation and in a full-term neonate following a forceps delivery and mild asphyxia.
