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International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
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Iatrogenic pneumothorax in mechanically ventilated children: Incidence, risk factors and other outcomes

Paulo Sérgio Lucas da Silva1, Vânia Euzébio de Aguiar1, Marcelo Cunio Machado Fonseca2

  • 1Department of Pediatrics, Pediatric Intensive Care Unit, Hospital do Servidor Público Municipal, Rua Castro Alves, 60, São Paulo 01532-900, Brazil.

Heart & Lung : the Journal of Critical Care
|February 15, 2015
PubMed

Insights

Iatrogenic pneumothoraces (IPs) occurred in 3% of pediatric intensive care unit patients on mechanical ventilation. Thoracic invasive procedures significantly predicted IPs, which were linked to higher mortality rates.

Area of Science:

  • Pediatric Critical Care Medicine
  • Pulmonary Medicine
  • Patient Safety

Background:

  • Iatrogenic pneumothoraces (IPs) are a potential complication in critically ill children.
  • Mechanical ventilation (MV) and invasive procedures increase the risk of IPs.

Purpose of the Study:

  • To determine the prevalence, risk factors, and outcomes of IPs in a pediatric intensive care unit (PICU).

Main Methods:

  • A 5-year prospective cohort study included 645 pediatric intensive care unit patients receiving mechanical ventilation.
  • Twenty cases of iatrogenic pneumothorax were compared to eighty control patients.

Main Results:

  • The overall prevalence of iatrogenic pneumothorax was 3%.
  • Thoracic invasive procedures were a significant predictor (OR 11) of iatrogenic pneumothorax.
  • Patients with iatrogenic pneumothorax had a significantly higher mortality rate.

Conclusions:

  • Thoracic invasive procedures are strongly associated with iatrogenic pneumothoraces in mechanically ventilated children.
  • Quality improvement programs may help prevent iatrogenic pneumothoraces.
Abstract

Keywords:
ChildrenIatrogenic pneumothoraxMechanical ventilationPediatric intensive care unitQuality improvement

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