Pulmonary interstitial emphysema is a risk factor for poor prognosis and a cause of air leaks

Yuri Tachibana, Hiroyuki Taniguchi, Yasuhiro Kondoh, Kensuke Kataoka, Naoki Hamada, Toshihiro Hashiguchi, Kazuya Ichikado, Tomoo Kishaba, Shuntaro Sato, Emiko Udo, Mikiko Hashisako, Junya Fukuoka

Research output: Contribution to journalArticle

Abstract

Background: Pulmonary interstitial emphysema is a rare, abnormal condition in which air pressure from the alveolar airspace tears the adjacent interstitial tissues of the lung and causes the formation of cystic spaces. Pulmonary interstitial emphysema is a known indication for mechanical ventilation in premature infants with neonatal respiratory distress syndrome, and it can be observed in various types of interstitial lung disease. Nevertheless, its pathogenesis and clinical impact remain unknown. Methods: We reviewed data from 433 cases of interstitial lung disease from an external consultation archive. Multidisciplinary diagnosis along with clinical and follow-up data, including events of air leaks such as pneumothorax and mediastinal emphysema, were obtained and compared to those of 150 control cases of interstitial lung disease without pulmonary interstitial emphysema. Results: We found 22 (5.1%) cases of interstitial lung disease with pulmonary interstitial emphysema. The diagnoses included idiopathic pulmonary fibrosis (5/22 [22.7%]), pleuroparenchymal fibroelastosis (4/22 [18.2%]), chronic hypersensitivity pneumonia (4/22 [18.2%]), and others (9/22 [40.9%]). Cases involving pulmonary interstitial emphysema demonstrated a significantly higher frequency of air leaks than did those without pulmonary interstitial emphysema (12/22 [54.5%] versus 23/150 [15.3%]; P < 0.001; odds ratio, 6.63) and were associated with worse prognosis (P = 0.009 [log-rank]) and a lower median percent forced vital capacity (73.2% versus 84.0%; P < 0.001). Conclusions: We found that pulmonary interstitial emphysema is an independent factor for poor prognosis, which also shows a trend to cause air leaks, including pneumothorax and mediastinal emphysema.

Original languageEnglish
Pages (from-to)444-450
Number of pages7
JournalRespiratory Investigation
Volume57
Issue number5
DOIs
Publication statusPublished - Sep 1 2019

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Pulmonary Emphysema
Air
Interstitial Lung Diseases
Mediastinal Emphysema
Pneumothorax
Newborn Respiratory Distress Syndrome
Air Pressure
Idiopathic Pulmonary Fibrosis
Vital Capacity
Tears
Artificial Respiration
Premature Infants
Pneumonia
Hypersensitivity
Referral and Consultation
Odds Ratio
Lung

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

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Pulmonary interstitial emphysema is a risk factor for poor prognosis and a cause of air leaks. / Tachibana, Yuri; Taniguchi, Hiroyuki; Kondoh, Yasuhiro; Kataoka, Kensuke; Hamada, Naoki; Hashiguchi, Toshihiro; Ichikado, Kazuya; Kishaba, Tomoo; Sato, Shuntaro; Udo, Emiko; Hashisako, Mikiko; Fukuoka, Junya.

In: Respiratory Investigation, Vol. 57, No. 5, 01.09.2019, p. 444-450.

Research output: Contribution to journalArticle

Tachibana, Y, Taniguchi, H, Kondoh, Y, Kataoka, K, Hamada, N, Hashiguchi, T, Ichikado, K, Kishaba, T, Sato, S, Udo, E, Hashisako, M & Fukuoka, J 2019, 'Pulmonary interstitial emphysema is a risk factor for poor prognosis and a cause of air leaks', Respiratory Investigation, vol. 57, no. 5, pp. 444-450. https://doi.org/10.1016/j.resinv.2019.03.008
Tachibana, Yuri ; Taniguchi, Hiroyuki ; Kondoh, Yasuhiro ; Kataoka, Kensuke ; Hamada, Naoki ; Hashiguchi, Toshihiro ; Ichikado, Kazuya ; Kishaba, Tomoo ; Sato, Shuntaro ; Udo, Emiko ; Hashisako, Mikiko ; Fukuoka, Junya. / Pulmonary interstitial emphysema is a risk factor for poor prognosis and a cause of air leaks. In: Respiratory Investigation. 2019 ; Vol. 57, No. 5. pp. 444-450.
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AU - Tachibana, Yuri

AU - Taniguchi, Hiroyuki

AU - Kondoh, Yasuhiro

AU - Kataoka, Kensuke

AU - Hamada, Naoki

AU - Hashiguchi, Toshihiro

AU - Ichikado, Kazuya

AU - Kishaba, Tomoo

AU - Sato, Shuntaro

AU - Udo, Emiko

AU - Hashisako, Mikiko

AU - Fukuoka, Junya

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Background: Pulmonary interstitial emphysema is a rare, abnormal condition in which air pressure from the alveolar airspace tears the adjacent interstitial tissues of the lung and causes the formation of cystic spaces. Pulmonary interstitial emphysema is a known indication for mechanical ventilation in premature infants with neonatal respiratory distress syndrome, and it can be observed in various types of interstitial lung disease. Nevertheless, its pathogenesis and clinical impact remain unknown. Methods: We reviewed data from 433 cases of interstitial lung disease from an external consultation archive. Multidisciplinary diagnosis along with clinical and follow-up data, including events of air leaks such as pneumothorax and mediastinal emphysema, were obtained and compared to those of 150 control cases of interstitial lung disease without pulmonary interstitial emphysema. Results: We found 22 (5.1%) cases of interstitial lung disease with pulmonary interstitial emphysema. The diagnoses included idiopathic pulmonary fibrosis (5/22 [22.7%]), pleuroparenchymal fibroelastosis (4/22 [18.2%]), chronic hypersensitivity pneumonia (4/22 [18.2%]), and others (9/22 [40.9%]). Cases involving pulmonary interstitial emphysema demonstrated a significantly higher frequency of air leaks than did those without pulmonary interstitial emphysema (12/22 [54.5%] versus 23/150 [15.3%]; P < 0.001; odds ratio, 6.63) and were associated with worse prognosis (P = 0.009 [log-rank]) and a lower median percent forced vital capacity (73.2% versus 84.0%; P < 0.001). Conclusions: We found that pulmonary interstitial emphysema is an independent factor for poor prognosis, which also shows a trend to cause air leaks, including pneumothorax and mediastinal emphysema.

AB - Background: Pulmonary interstitial emphysema is a rare, abnormal condition in which air pressure from the alveolar airspace tears the adjacent interstitial tissues of the lung and causes the formation of cystic spaces. Pulmonary interstitial emphysema is a known indication for mechanical ventilation in premature infants with neonatal respiratory distress syndrome, and it can be observed in various types of interstitial lung disease. Nevertheless, its pathogenesis and clinical impact remain unknown. Methods: We reviewed data from 433 cases of interstitial lung disease from an external consultation archive. Multidisciplinary diagnosis along with clinical and follow-up data, including events of air leaks such as pneumothorax and mediastinal emphysema, were obtained and compared to those of 150 control cases of interstitial lung disease without pulmonary interstitial emphysema. Results: We found 22 (5.1%) cases of interstitial lung disease with pulmonary interstitial emphysema. The diagnoses included idiopathic pulmonary fibrosis (5/22 [22.7%]), pleuroparenchymal fibroelastosis (4/22 [18.2%]), chronic hypersensitivity pneumonia (4/22 [18.2%]), and others (9/22 [40.9%]). Cases involving pulmonary interstitial emphysema demonstrated a significantly higher frequency of air leaks than did those without pulmonary interstitial emphysema (12/22 [54.5%] versus 23/150 [15.3%]; P < 0.001; odds ratio, 6.63) and were associated with worse prognosis (P = 0.009 [log-rank]) and a lower median percent forced vital capacity (73.2% versus 84.0%; P < 0.001). Conclusions: We found that pulmonary interstitial emphysema is an independent factor for poor prognosis, which also shows a trend to cause air leaks, including pneumothorax and mediastinal emphysema.

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