Persistent Interstitial Pulmonary Emphysema: Another Complication of the Respiratory Distress Syndrome

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Abstract
Persistent interstitial pulmonary emphysema (PIPE) was observed in 22 infants during the neonatal period. All of the infants experienced respiratory distress during the 1st few days of life, and 21 were treated for the respiratory distress syndrome with artificial ventilation or O2 or both. Ten infants developed a localized form of PIPE, with air-filled interstitial cysts measuring up to 3.0 cm in diameter confined to 1 or more lobes of lung. The involved segment of lung was resected in 7 of these infants, all of whom survived. The remaining 3 died and autopsies were performed. A diffuse form of PIPE was observed in the other 12 infants. Numerous cysts that were predominantly small (less than 0.3 cm) were seen in all lobes of both lungs. These infants received high concentrations of O2 for prolonged periods, resulting in bronchopulmonary dysplasia in 11 of the infants. All 12 infants died. PIPE is characterized histologically by air-filled interstitial cysts partially lined by multinucleated giant cells.