In neonates, what does increased ventilation support while having pulmonary interstitial emphysema often result in?

In the context of neonates with pulmonary interstitial emphysema, increased ventilation support typically leads to a worsening of symptoms rather than improvement. Pulmonary interstitial emphysema is characterized by air leakage into the interstitial spaces of the lungs, often resulting from positive pressure ventilation or mechanical ventilation. As ventilation support is increased—intended to enhance oxygenation or assist with respiratory efforts—this can inadvertently contribute to further air trapping or distension of alveoli and interstitial spaces, thereby aggravating the condition.

When air is forced into an already compromised lung, the additional pressure may lead to a focus on over-expansion, which can further disrupt the delicate balance of the neonatal lung architecture. Therefore, rather than stabilizing the respiratory status or improving oxygenation, increased ventilation in this scenario can exacerbate the pulmonary interstitial emphysema and worsen the patient's overall condition. This highlights the complexity of managing ventilatory support in neonates, particularly in those with already vulnerable pulmonary structures.