Ventilator-induced pulmonary pseudocysts in preterm neonates

Twenty-three pulmonary pseudocysts were identified in 20 preterm neonates undergoing mechanically assisted ventilation. Most of the pseudocysts occurred in a right parahilar location; cysts were either single (13) or multiple/multilocular (10). The pseudocysts persisted from less than 2 days to longer than 3 months (modal duration, 7 days), and they were commonly associated with generalized pulmonary interstitial emphysema (18 of 20), pneumothorax (18 of 20), bronchopulmonary dysplasia (16 of 20), and pneumomediastinum (six of 20). The reason for the predominantly right parahilar location of these pseudocysts remains uncertain. Pulmonary pseudocysts are almost always right-sided and are associated with pulmonary interstitial emphysema and pneumothoraces; complete resolution usually occurs.