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Related Experiment Videos

[Surgical approach in persistent neonatal pneumothorax].

V Martínez Ibáñez, A Fina, S Salcedo

    Cirugia Pediatrica : Organo Oficial De La Sociedad Espanola De Cirugia Pediatrica
    |April 1, 1989
    PubMed
    Summary

    Tension pneumothorax is a serious complication of mechanical ventilation in neonates. Surgical closure offers a 100% survival rate for neonates with persistent pulmonary fistulas, improving overall outcomes.

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    Area of Science:

    • Neonatal Medicine
    • Pediatric Surgery
    • Critical Care

    Context:

    • Mechanical ventilation is frequently required for neonates in the Neonatal Intensive Care Unit (NICU).
    • Tension pneumothorax is a significant complication, affecting 136 out of 837 neonates requiring ventilation in this study.
    • A defined protocol for managing tension pneumothorax in neonates was implemented.

    Purpose:

    • To report the experience and outcomes of neonates with tension pneumothorax managed with a specific protocol.
    • To detail the steps of the management protocol, including early diagnosis, drainage, selective intubation, and surgical closure.
    • To evaluate the efficacy of surgical closure in cases of persistent pulmonary fistula despite conservative treatment.

    Summary:

    • A protocol involving early diagnosis, underwater-seal drainage, suction drainage, selective intubation of the contralateral bronchus, and surgical closure was applied.

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  • The protocol was particularly detailed for 15 neonates who required surgical intervention.
  • Surgical management resulted in 100% survival during surgery, 93% in the postoperative phase, and 78.5% overall survival.

    • Impact:

    • Surgical closure is recommended for neonates with persistent pulmonary fistulas that do not resolve with aggressive conservative management.
    • This approach significantly improves survival rates in neonates experiencing tension pneumothorax as a complication of mechanical ventilation.
    • The study highlights the critical role of timely surgical intervention in managing severe respiratory complications in critically ill neonates.