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Related Concept Videos

Mechanical Ventilation I: Indication and Settings01:29

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Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
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Pneumothorax-I01:26

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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.
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Factors Affecting Pulmonary Ventilation01:19

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Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
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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:
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Ventilatory Modes01:14

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Mechanical ventilators are life-saving devices that support or replace spontaneous breathing. They deliver breaths to patients through varying methods known as ventilator modes. Understanding these modes is critical for healthcare providers managing patients with respiratory failure.
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In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
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Updated: Nov 11, 2025

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
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Association between ventilatory settings and pneumothorax in extremely preterm neonates.

Felipe Y Matsushita1, Vera L J Krebs1, Werther B de Carvalho1

  • 1Departamento de Pediatria, Divisao de Neonatologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.

Clinics (Sao Paulo, Brazil)
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Summary

Ventilator settings like PEEP, PIP, and DP did not increase pneumothorax risk in extremely low birth weight neonates. This finding is crucial for neonatal intensive care unit (NICU) management of premature infants.

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Area of Science:

  • Neonatal Medicine
  • Pediatric Critical Care
  • Respiratory Physiology

Background:

  • Pneumothorax is a serious complication in neonates, particularly those with extremely low birth weight (ELBW).
  • Understanding risk factors for pneumothorax is vital for improving outcomes in vulnerable infants.

Purpose of the Study:

  • To investigate the association between specific ventilatory parameters and the risk of pneumothorax in ELBW neonates.
  • To determine if positive end-expiratory pressure (PEEP), peak inspiratory pressure (PIP), and driving pressure (DP) influence pneumothorax development.

Main Methods:

  • A retrospective cohort study of 257 ELBW neonates in a NICU from 2012-2017.
  • Compared highest PEEP, PIP, and DP values within the first 7 days of life between neonates with and without pneumothorax requiring chest drainage.
  • Used a matched control group to adjust for confounding factors like CRIB II score, birth weight, and gestational age.

Main Results:

  • No statistically significant difference was found in PEEP, PIP, or DP values between neonates who developed pneumothorax and those who did not.
  • These findings remained consistent even after adjusting for potential confounding variables.

Conclusions:

  • Pressure-related ventilatory settings (PEEP, PIP, DP) in the first 7 days of life are not associated with an increased risk of pneumothorax in mechanically ventilated ELBW neonates.
  • This suggests that other factors may play a more significant role in the development of pneumothorax in this population.