Slide 1 of 13
Slide 1 - Emphysema in Pediatrics
Emphysema in Pediatrics
Presented by Gauri Narkar Roll No: 92
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Photo by Annie Spratt on Unsplash
Emphysema in Pediatrics: Etiology, Diagnosis & Management
Generated from prompt:
Create a clean, modern medical PowerPoint presentation titled "Emphysema in Pediatrics" with the following slides: 1. Title Slide: ONLY the title "Emphysema in Pediatrics" (no key focus areas, no subtitles). Include Presented by Gauri Narkar, Roll No: 92 in small professional formatting. 2. Definition 3. Classification – Based on Etiology 4. Classification – Based on Pathology (Panacinar, Centrilobular, Paraseptal, Irregular) 5. Etiology (Congenital, Acquired, Genetic – Alpha-1 Antitrypsin Deficiency) 6. Pathophysiology (Flow sequence diagram style) 7. Clinical Features (Infants CLE, Genetic Emphysema) 8. Investigations 9. Management – General & Medical 10. Management – Surgical 11. Complications Use a professional medical theme with subtle blue tones, clean layout, bullet formatting, and section divider slides.
Comprehensive overview of emphysema in children, covering definition, classifications (etiology & pathology), pathophysiology, clinical features, investigations, medical/surgical management, complications, and key takeaways for early diagnosis and多学科
February 22, 202613 slides
Slide 2 of 13
Slide 2 - Definition
- Abnormal enlargement of the alveoli accompanied by loss of pulmonary elasticity
- Permanent enlargement of air spaces (alveoli) due to breakdown of alveolar walls
- Reduced alveolar surface area for gas exchange leading to decreased oxygen supply
- In pediatrics: often congenital forms like Congenital Lobar Emphysema (CLE) or early-onset due to genetic factors
Source: https://en.wikipedia.org/wiki/Emphysema
Slide 3 of 13
Slide 3 - Classification – Based on Etiology
- Congenital: Congenital Lobar Emphysema (CLE) - overinflation of one or more lung lobes in infants
- Acquired: Secondary to infections, aspiration, or prolonged mechanical ventilation
- Genetic: Alpha-1 Antitrypsin Deficiency (AATD) - mutation in SERPINA1 gene leading to early emphysema
Source: https://en.wikipedia.org/wiki/Emphysema; https://en.wikipedia.org/wiki/Alpha-1_antitrypsin_deficiency
Slide 4 of 13
Slide 4 - Classification – Based on Pathology
| Type | Description | Key Associations |
|---|---|---|
| Panacinar (Panlobular) | Involves entire secondary lobule/alveolar duct | AATD, pediatric/swyer-james |
| Centrilobular (Centriacinar) | Affects central part of lobule | Smoking-related (adults) |
| Paraseptal (Distal Acinar) | Distal acinar regions adjacent to septa | Bullous emphysema |
| Irregular (Paracicatricial) | Irregular involvement with fibrosis | Scarring, TB, infections |
Source: https://en.wikipedia.org/wiki/Emphysema
Slide 5 of 13
Slide 5 - Etiology
- Congenital: Abnormal cartilage in bronchioles (CLE) leading to air trapping
- Acquired: Infections (viral/bacterial), aspiration, barotrauma from ventilation
- Genetic: AATD - SERPINA1 mutation, protease-antiprotease imbalance, affects 1 in 2500 Europeans, early onset lung disease (20-50 yrs, but peds possible)
Source: https://en.wikipedia.org/wiki/Emphysema; https://en.wikipedia.org/wiki/Alpha-1_antitrypsin_deficiency; https://en.wikipedia.org/wiki/Congenital_lobar_emphysema
Slide 6 of 13
Slide 6 - Pathophysiology
| Stage | Description |
|---|---|
| 1. Etiologic Trigger | Genetic defect (AATD), bronchial cartilage deficiency (CLE), inflammation |
| 2. Protease-Antiprotease Imbalance | Unopposed neutrophil elastase activity due to low/defective A1AT |
| 3. Tissue Destruction | Breakdown of elastin fibers and alveolar septal walls |
| 4. airspace Enlargement | Abnormal permanent dilation of alveoli/distal airspaces |
| 5. Loss of Elasticity | Reduced lung recoil and radial traction on airways |
| 6. Functional Consequence | Air trapping, hyperinflation, V/Q mismatch, hypoxemia |
Source: https://en.wikipedia.org/wiki/Emphysema; https://en.wikipedia.org/wiki/Alpha-1_antitrypsin
Slide 7 of 13
Slide 7 - Clinical Features
- Infants with CLE: Progressive dyspnea from birth/early infancy, tachypnea, wheezing, decreased breath sounds on affected side, recurrent pneumonia
- Genetic Emphysema (AATD): Shortness of breath, wheezing, chronic cough, recurrent lung infections, early-onset COPD-like symptoms (20-50 years, but neonatal jaundice/liver issues in peds)
- Variable severity; may mimic asthma or bronchiolitis
Source: https://en.wikipedia.org/wiki/Alpha-1_antitrypsin_deficiency; https://en.wikipedia.org/wiki/Emphysema
Slide 8 of 13
Slide 8 - Investigations
- Chest X-ray: Hyperlucency, lobar emphysema, flattened diaphragm, mediastinal shift
- HRCT: Characterize emphysema type (panacinar etc.), rule out other pathology
- Pulmonary Function Tests: Obstructive pattern (FEV1/FVC <70%), air trapping (RV↑)
- Alpha-1 Antitrypsin Levels & Phenotyping: PI*ZZ for severe deficiency
- Echocardiography: Assess for pulmonary hypertension
- Bronchoscopy: Evaluate airway anomalies in CLE
Slide 9 of 13
Slide 9 - Management – General & Medical
- General: Supplemental oxygen, mechanical ventilation if severe distress, nutritional support
- Medical: Bronchodilators (salbutamol), inhaled corticosteroids for inflammation
- Antibiotics for secondary infections, vaccinations (influenza, pneumococcal)
- AAT Augmentation Therapy (IV Prolastin etc.) for confirmed deficiency - slows progression
- Smoking avoidance (relevant for older peds/adolescents), pulmonary rehab
Source: https://en.wikipedia.org/wiki/Alpha-1_antitrypsin_deficiency
Slide 10 of 13
Slide 10 - Management – Surgical
- Surgical Resection: Lobectomy for localized CLE causing significant compression (80-90% success)
- Lung Volume Reduction Surgery (LVRS): Rarely in severe diffuse emphysema (adults mainly)
- Lung Transplantation: For end-stage disease unresponsive to medical therapy
- Bullectomy: For large bullae causing issues
Slide 11 of 13
Slide 11 - Complications
- Acute: Pneumothorax, respiratory failure requiring ventilation
- Chronic: Progressive respiratory insufficiency, pulmonary hypertension, cor pulmonale
- Infections: Recurrent pneumonia, bronchiectasis
- Growth & Development: Failure to thrive in infants
- Comorbidities: Osteoporosis (steroid use), liver disease (AATD)
Source: https://en.wikipedia.org/wiki/Emphysema; https://en.wikipedia.org/wiki/Alpha-1_antitrypsin_deficiency
Slide 12 of 13
Slide 12 - Thank You
Key Takeaways: Early diagnosis and management crucial for pediatric emphysema Tailor approach to etiology (CLE vs AATD) Multidisciplinary care improves outcomes
Questions?
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Slide 13 of 13
Slide 13 - Clinical and Management Section
2
Clinical Features to Complications
Diagnosis, Treatment, and Prognosis
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