Pulmonary interstitial emphysema in mechanically ventilated premature infants is a serious complication that \r\nis diffcult to manage and is associated with a poor prognosis [1]. We describe a premature infant with respiratory \r\ninsuffciency secondary to severe pulmonary interstitial emphysema that was managed with nasopharyngeal high-\r\nfrequency oscillatory ventilation, as a non-invasive mode of ventilation. \r\nOur case report does not clearly differentiate whether the improvement in gas exchange and eventual resolution \r\nof PIE are attributable to the use of non-invasive HFOV or to the use more appropriate low frequency (7Hz) with the \r\nnon-invasive approach. Further studies of NP-HFOV use in infants with PIE are needed to support our report \r\nConclusion: NP-HFOV may be utilized in infants with PIE associated with compromised respiratory function. NP�¬HFOV may decrease the chance of further pulmonary complications, including pneumonia and lung atelectasis, and facilitate care of sick infants while on NP-HFOV.
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