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Post-extubation atelectasis in ventilated newborn infants
J C Odita1, M Kayyali, A Ammari
1Department of Radiology, Hamad Medical Corporation, Doha, State of Qatar.
Insights
Post-extubation atelectasis (PEA) is common in neonates. Risk factors include multiple intubations, patent ductus arteriosus, and neonatal sepsis, suggesting prophylactic physiotherapy may help prevent lung collapse.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Critical Care
Background:
- Post-extubation atelectasis (PEA) is the most frequent cause of lung collapse in neonates requiring mechanical ventilation.
- Understanding the clinical and radiological characteristics of PEA is crucial for timely intervention.
Purpose of the Study:
- To describe the clinical and radiological features of post-extubation atelectasis in ventilated neonates.
- To identify risk factors associated with the development of PEA.
Main Methods:
- Retrospective analysis of 47 ventilated infants who developed PEA within 24 hours of extubation.
- Comparison with a control group of ventilated infants without PEA.
- Radiographic pattern classification of atelectasis.
Main Results:
- Three radiographic patterns of PEA were identified: transient unilobar, multilobar, and progressive complete lung collapse.
- Significant associations were found between PEA and multiple intubations (P < 0.02), patent ductus arteriosus (P < 0.001), and neonatal sepsis (P < 0.05).
Conclusions:
- PEA presents with diverse radiographic patterns in ventilated neonates.
- Multiple intubations, patent ductus arteriosus, and neonatal sepsis are significant risk factors for PEA.
- Prophylactic physiotherapy is recommended for ventilated infants, especially those with identified risk factors.
Abstract:
Post-extubation atelectasis (PEA) constitutes the commonest cause of lung collapse in ventilated neonates. The clinical and radiological features of 47 ventilated infants who developed PEA within 24 h of extubation are reported. Three main radiographic patterns of atelectasis were identified: (1) transient unilobar collapse resolving within 12 h of extubation (19 cases), (2) multilobar atelectasis developing over a 48-h period (18 cases), and (3) progressive atelectasis resulting in complete collapse of a whole lung. A similar number of ventilated infants without PEA served as controls. We found a significant association between the incidence of PEA and multiple intubation (P < 0.02), presence of patent ductus arteriosus (P < 0.001) and neonatal sepsis (P < 0.05). Prophylactic physiotherapy is recommended for ventilated infants, particularly those with the above risk factors.