We read with interest the study by Hathorn et al1 presenting a series of six cases with selective bronchial occlusion using a balloon angiography catheter in children with pulmonary air leaks. This study confirms the feasibility of one-sided ventilation in massive pulmonary air leaks. This sophisticated technique was first described by Lewis et al2 in 1988 in a series of neonates exclusively. In contrast to the paper by Hathorn et al they used a Swan-Ganz catheter to occlude the bronchus. Hathorn et al's case series included small preterm infants to a 6-year-old girl. Due to the frequent need of ventilatory support, preterm infants have a considerable risk of developing pulmonary emphysema, extending sometimes to giant bullous emphysema.
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