CCAM

[Guest danw]

Hi All,

we have an infant with CCAM. Do You have any experiences with treatment of this disorder?

Thanx.

[Stefan Johansson]

Most (all?) baies I've come across were managed conservatively.

Does the CCAM in your infant have any mass (compression) effects?

[Guest danw]

Yes, mediastinum is deviated towards the healthy (right) side, baby is still on vent, tomorow we will do scintigraphy of lungs and then we decide what we´ll be doing.

[JACK]

We had a baby about two months back.

He was a 34 week preterm baby, with massive CONG CAM of right lung with severe shift of mediatinum to the left. We had a hard time maintaining his oxygention. Within hours he was on very high pressures on conventional ventilator. Predictably developed bilateral pnemothoraces and had bilateral ICT in situ by the end of 3 hours of life.

But oxygenation was still a problem . We shifted him to HFOV and then used inhaled nitric oxide to try to balance V/Q matching.

That worked at dose of 40ppm. He stabilized. After few days he was "critically stable " enough to be operated and the lesion was excised by a lobectomy.

Following surgery he went to act very peculiarly after 2 weeks behaving like BPD. He again developed a left pnemothorax which ultimately resolved. He could not be weaned from ventilator support , and required unconventional institution of steroids as a last ditch effort. Now he is off steroids, recovering from fungal sepsis, on tube feeds. on low parameters on conventional ventilator. He is alert , looking around.

Both the baby and the doctor are waiting for the day he will be extubated.

He is now a 2 month old boy.

[JACK]

I will just update on the condition of the baby. He is now more than 5 months old. Now on oral feeding. Other than supplements , is not recieiving any medications. Is receiving supplemental oxygen 1 l/min. Is active and doing well.

[Stefan Johansson]

Good to hear!

[JACK]

Happy to tell everyone, that the baby was discharged home last week. A very emotional moment for the parents and the NICU staff.

Baby had been weaned off oxygen for two weeks prior to discharge

[Stefan Johansson]

Happy to tell everyone, that the baby was discharged home last week.

Great news! This is one of the nice aspects of neonatal care, happy endings!