3. Air leak syndrome
Definition:-
Alveolar rupture with escape of air out of the alveoli.
Interstitioum first stage.
pleural rupture.
( mediastinum, pericardium , abdominal cavity, under the skin)
6. where air is trapped between
the tiny air sacs
Encircling the smallest blood
vessels and bronchi.
occurs in poor lung
compliance.
Pulmonary interstitial emphysema
(PIE)
7. Collect air in the interstitium
Compressed the small airway
and vessels
V/Q mismatches
Deterioration of blood gas
15. Pneumothorax
common of air leak , occurring in 1 – 2 % of all newborn.
Pneumothorax refers to the presence of air
in the pleural cavity between the visceral and parietal
pleura ( chest wall and lung)
17. the lung is collapse 10% -30%. without further
expansion of the pneumothorax.
Result of the weak rupture of alveolar area.
Often Asymptomatic.
May resolve without complication.
18. Addition of new air through the rupture with each
breath.
Continuously Large and large air trap.
The lung collapse under the pressure.
The great vessels and heart shift toward
and cardiac function becomes compromised.
19.
20. Increase respiratory distress.
Nasal flaring.
Desaturation.
Cynosis.
Examination chest:-
Asymmetry in chest movement.
Diminished of breath sound.
Signs and symptom
25. Thoracentesis (needle aspiration).
Emergency treatment of a symptomatic
pneumothorax.
Insert needle 4th intercostal space anterior axillary
line.
21- 23 butterfly gauge.
26. Chest tube:-
Definitive treatment is insertion of an 8 - 10 French
chest tube . attached to continuous suction.
Follow-up auscultation, transillumination, and x-ray.
29. Pneumomediastinum
Large collections of air may result in tachypnea and
cyanosis .
The diagnosis is made on a chest radiograph.
Usually resolves spontaneously, and requires no
specific treatment.
36. Pneumopericadium
Management:
Infants who are asymptomatic may not need
intervention (close monitoring) .
Ventilator pressures should be minimized .
Pericardial drainage :
Symptomatic infants
This procedure is both diagnostic and therapeutic
38. Pneumoperitonium
Pneumoperitoneum is dissection of air into the
peritoneum.
Pneumoperitoneum may occur when extrapulmonary
air decompresses into the peritoneal cavity .
The diagnosis is made on an abdominal radiograph
and usually has little clinical significance .
42. It typically presents as crepitus detected by palpation.
It usually has no clinical significance.
although large air collections in the neck may
cause tracheal compromise.
Subcutaneous emphysema.
Salam alaykom . To day I will tallk about ALS and our presentation insallah will be very simple and eazy .
First of all . When you hear the Air leak syndrome what is come in your minde?
Of course you will imaging there is leak of air from the lung and many will imagen pneumothorax or other.
So lets explane how ALS accure and it diveded to how many type
Firs off all . The ALS syndrome meaning escaping of air out of the alveoli and go to intestitioum first stage
and well call PIEPULMONARY INTERSTITIAL EMPHYSEMA (PIE) where air is trapped between the tiny air sacs, encircling the smallest blood vessels and bronchi.
PNEUMOTHORAX where the air is trapped inside the chest between the chest wall and the lung, causing the lung to collapse.
PNEUMOMEDIASTINUM where air is trapped in the middle part of the chest.
the heart, (Pneumopericardium),
get under the skin(Subcutaneous Emphysema).
leak into the abdomen (Pneumoperitoneum).
surround the kidneys (Pneumoretroperitoneum).
There is a loss of intrapleural negative pressure causing lung collapse.
Diagnosis is suspected by deterioration of respiratory status, by transillumination of the chest with a fiberoptic probe, or both. Diagnosis is confirmed by chest x-ray or, in the case of tension pneumothorax, return of air during thoracentesis
Emergent treatment of a symptomatic pneumothorax
• Localize site: 2
2nd nd-3rd rd intercostal space along
midclavicular line
• Cleanse the area
• 22/24 g
angio attached to 20 ml syringe with a
stopcock
• Palpable 3
3rd rd rib at midclavicular line and insert needle
above the rib
• Advance needle till air is withdrawn in syringe
If a tube can be placed in the area where air is collecting, continuous suction on the tube can remove the air until the leak seals over. This is the most common treatment.
In a pneumothorax a chest tube is placed between two ribs and into the chest cavity between the lungs and the chest wall.
This is the most common treatment.
Most small pneumothoraces resolve spontaneously, but larger and tension pneumothoraces require evacuation of the air in the pleural cavity. In tension pneumothorax, a scalp vein needle or an angiocatheter and syringe can be used to temporarily evacuate free air from the pleural space. Definitive treatment is insertion of an 8 or 10 French chest tube attached to continuous suction. Follow-up auscultation, transillumination, and x-ray confirm that the tube is functioning properly
Abrupt onset of hemodynamic compromise due to cardiac tamponade
Pneumoperitoneum is dissection of air into the peritoneum. It is generally not clinically significant but must be distinguished from pneumoperitoneum due to a ruptured abdominal viscus, which is a surgical emergency. Diagnosis is made by abdominal x-ray and physical examination. Clinical symptoms that include abdominal rigidity, absent bowel sounds, and signs of sepsis suggest abdominal viscus injury.
Subcutaneous emphysema typically occurs in the face, neck, or supraclavicular region. It typically presents as crepitus detected by palpation. It usually has no clinical significance, although large air collections in the neck may cause tracheal compromise