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Pneumothorax in the newborn. Changing pattern.

V Y Yu, S W Liew, N R Robertson

    Archives of Disease in Childhood
    |June 1, 1975
    PubMed
    Summary
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    Pneumothorax in newborns is a serious complication, especially for preterm infants with hyaline membrane disease (HMD) requiring respiratory support. Prompt diagnosis and treatment are crucial for survival.

    Area of Science:

    • Neonatal Medicine
    • Pediatric Pulmonology
    • Critical Care

    Background:

    • Pneumothorax is a significant concern in neonates, with varying incidence and risk factors.
    • Hyaline membrane disease (HMD) is a common condition in preterm infants requiring respiratory support.
    • The relationship between HMD, respiratory support, and pneumothorax development needs further elucidation.

    Purpose of the Study:

    • To investigate the clinical course and outcomes of pneumothorax in newborn infants.
    • To identify risk factors and patterns of pneumothorax in term and preterm neonates.
    • To evaluate the impact of respiratory support on pneumothorax development and management.

    Main Methods:

    • Retrospective study of 34 newborn infants with pneumothorax over 2.5 years.

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  • Analysis of clinical presentation, underlying pathology, and management strategies.
  • Comparison of outcomes between term and preterm infants, and those with and without HMD.

    • Main Results:

    • Overall incidence of pneumothorax was 3/1000 live births.
    • Preterm infants with HMD requiring continuous distending pressure (CDP) or intermittent positive pressure ventilation (IPPV) had a higher incidence (15%) of pneumothorax.
    • Intrapleural drainage was required in most preterm infants with HMD; 5 deaths occurred, all in this group.
    • Recurrence of pneumothorax was noted in infants on CDP/IPPV.

    Conclusions:

    • Pneumothorax is an increasingly important complication of HMD in preterm infants, particularly those receiving CDP.
    • Prompt diagnosis and management, including chest drainage, are vital for improving outcomes.
    • Sudden deterioration in high-risk infants may indicate pneumothorax, necessitating immediate intervention.