Outcomes of spontaneous pneumothorax in neonates: treatments vs. expectant management
Anat Margaliot1, Laurence Mangel1, Yarden Waxman1
1Department of Neonatology, Tel Aviv University, Tel Aviv, Israel.
Background:
Neonatal pneumothorax is dependent on severity of symptoms and leak size. Treatment of Pneumothorax with Nitrogen washout is controversial.
Objective:
To compare outcomes of neonates treated for spontaneous pneumothorax (SP) compared with those managed expectantly.
Methods:
A retrospective review of medical records of neonates (≥34weeks) diagnosed with SP born between 2011 and 2021. Neonatal characteristics and outcomes were compared between neonates treated for SP with either targeted oxygen therapy (to stabilize saturation ≥93%) or nitrogen washout and those under expectant management.
Results:
Among neonates with respiratory distress and desaturation (n = 64), nitrogen washout reduced median time to resolution compared to targeted oxygen therapy (31 [12-67] vs 81 [31.8-123.5] hours, p = 0.012). Expectantly managed neonates with distress (n = 87) experienced delayed feeding initiation, while time to resolution and hospital stay were similar.
Conclusion:
Nitrogen washout is superior to targeted oxygen therapy in time to resolution in infants presenting with respiratory distress and desaturation.
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