Conservative treatment with high-frequency oscillatory ventilation and corticosteroids in infantile lobar emphysema

Infantile lobar emphysema (ILE) is a disease with a wide spectrum of etiology. The typical clinical pictures may vary from no symptoms, to mild or severe respiratory distress. Surgical lobectomy is the treatment of choice in most studies. Recent evidence demonstrates that its clinical course may be reversible or progressive. Not all cases deserve surgical lobectomy. We report our experience of treating five infants by combining high-frequency oscillatory ventilation (HFOV) and corticosteroids. The lobar emphysema of three infants resulting from prolonged mechanical ventilation resorbed, but the other two infants with cardiovascular anomalies expired. We observe that conservative management combining HFOV and corticosteroids deserves a place in treating ILE.