Journal of pediatric surgery
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A bronchopleural fistula (BPF) may complicate the management of patients with major pulmonary disease or thoracic surgery. Neonates with idiopathic respiratory distress syndrome and requiring ventilation are especially susceptible to pulmonary barotrauma, which may result in a BPF. Morbidity and mortality are consistently high. ⋯ When using equal increments of PIP and PEEP, PEEP will have over a sixfold greater effect on air leak than doses PIP. These data suggests that PIP should be increased preferentially when ventilating patients with BPF in order to minimize air leak. PEEP less than 6 cm H2O can be used without any significant increase in the volume of air lost.