Open Cyst Drainage for Reliable Decompression in a Critically Ill Neonate with Congenital Pulmonary Airway Malformation

INTRODUCTION: Congenital pulmonary airway malformation (CPAM) is a rare congenital lung lesion that is often diagnosed prenatally. Large macrocystic lesions can cause severe respiratory compromise after birth, requiring urgent decompression. Although staged management with cyst drainage followed by delayed resection has been reported, the optimal method for achieving reliable decompression in critically unstable neonates remains unclear. We report a case in which emergency open cyst drainage under direct visualization enabled secure catheter placement and reliable decompression before definitive surgery.