Related Experiment Video

Updated: Jun 3, 2026

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
05:50

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

Published on: March 12, 2020

Positive airway pressure levels and pneumothorax: a case-control study in very low birth weight infants

Ratchada Kitsommart1, Kitsommart Ratchada1, Asad Rahman

  • 1Division of Neonatology, Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|April 6, 2011
PubMed

Insights

The incidence of pneumothorax (PTx) in very low birth weight infants was low following new protocols. Elevated positive airway pressure (Paw) levels were associated with PTx development in these infants.

Area of Science:

  • Neonatal medicine
  • Pediatric respiratory research

Background:

  • Evidence-based protocols for early continuous positive airway pressure (CPAP) and high positive airway pressure (Paw) were implemented.
  • Pneumothorax (PTx) is a significant risk in very low birth weight infants.

Purpose of the Study:

  • To evaluate the incidence of PTx and associated Paw levels in very low birth weight infants within the first 5 days of life (DOL).

Main Methods:

  • A retrospective review identified infants who developed PTx from 2004 to 2007.
  • Controls were matched by birth weight, gestational age, and ventilatory support.
  • Time-weighted averages of Paw were calculated.

Main Results:

  • The PTx incidence was 3.8% (25 infants), with 23 occurring within the first 5 DOL.
  • PTx diagnosis occurred at a median of 14 hours of life, with 74% on mechanical ventilation.
  • Infants with PTx showed sustained high Paw levels, unlike controls where Paw decreased.

Conclusions:

  • The implemented protocols resulted in a low rate of PTx.
  • An association between high Paw levels and PTx was observed.
  • Elevated Paw may serve as an early indicator of PTx or severe lung disease.
Abstract

Related Concept Videos

Pneumothorax-I01:26

Pneumothorax-I

A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax II: Pathophysiology01:08

Pneumothorax II: Pathophysiology

Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance between...
Pneumothorax-II01:27

Pneumothorax-II

Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Atelectasis II: Pathophysiology01:10

Atelectasis II: Pathophysiology

Atelectasis develops when alveoli lose their air and collapse inward. Because lung tissue is naturally elastic, these air sacs shrink rather than remaining open. Collapsed alveoli are no longer ventilated, reducing their role in gas exchange. Blood flow may continue in these regions, creating a ventilation–perfusion mismatch. Clinical findings include decreased breath sounds, dullness to percussion, reduced chest expansion, and decreased tactile fremitus as sound transmission through collapsed...
Pressure Relationships in Thoracic Cavity01:24

Pressure Relationships in Thoracic Cavity

Breathing, otherwise known as pulmonary ventilation, is the process of air movement into and out of the lungs. The main mechanisms propelling pulmonary ventilation are atmospheric pressure (Patm), intra-pulmonary (Ppul ) or intra-alveolar pressure (Palv) within the alveoli, and intrapleural pressure (Pip) within the pleural cavity.
Breathing Mechanisms
Both intra-alveolar and intrapleural pressures rely on specific lung properties. The ability to breathe—allowing air to enter the lungs during...
Pneumonia I: Introduction01:30

Pneumonia I: Introduction

Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...