Which statement about PIE management is not supported by the source?

Which statement about PIE management is not supported by the source?

• A. HFV is used as a treatment
• B. Lobectomy may be performed
• C. PEEP to stent airway along with PIP<30 and 100% O2 for 30 minutes
• D. Nebulized bronchodilators used as the sole therapy

Answer: (D)

PIE management focuses on minimizing volutrauma and keeping the lung recruited while reducing the risk of further air leakage. The approach described as using high-frequency ventilation provides very small tidal volumes with controlled mean airway pressure, which helps stabilize the fragile lung without large pressure swings. In localized PIE that doesn’t respond to supportive care, removing the affected portion of the lung through lobectomy is a potential option. Another strategy is to use PEEP to hold open the airways (stent them) while keeping peak inspiratory pressures low, such as aiming for a PIP under 30 cm H2O, and employing 100% oxygen for a period (about 30 minutes) to promote resorption of the interstitial air. Nebulized bronchodilators as the sole therapy do not address the underlying problem of air in the interstitium; they may be helpful if there is concurrent airway reactivity but cannot treat PIE by themselves.

PIE management focuses on minimizing volutrauma and keeping the lung recruited while reducing the risk of further air leakage. The approach described as using high-frequency ventilation provides very small tidal volumes with controlled mean airway pressure, which helps stabilize the fragile lung without large pressure swings. In localized PIE that doesn’t respond to supportive care, removing the affected portion of the lung through lobectomy is a potential option. Another strategy is to use PEEP to hold open the airways (stent them) while keeping peak inspiratory pressures low, such as aiming for a PIP under 30 cm H2O, and employing 100% oxygen for a period (about 30 minutes) to promote resorption of the interstitial air. Nebulized bronchodilators as the sole therapy do not address the underlying problem of air in the interstitium; they may be helpful if there is concurrent airway reactivity but cannot treat PIE by themselves.