Symptomatic Spontaneous Pneumothorax in the Newborn : Comorbidities and Outcomes.

Joo,  Ji Won; Yang,  Eun Mi; Sohn,  Young Jun; Kim,  Mi Jeong; Song,  Eun Song; Choi,  Young Youn; Byun,  Hyung Suck

Original Article

Journal of the Korean Society of Neonatology 2008;15(2):166-171.
Published online November 1, 2008.

Symptomatic Spontaneous Pneumothorax in the Newborn : Comorbidities and Outcomes.

Ji Won Joo, Eun Mi Yang, Young Jun Sohn, Mi Jeong Kim, Eun Song Song, Young Youn Choi, Hyung Suck Byun

¹Department of Pediatrics, Collage of Medicine, Chonnam University, Gwangju, Korea. yychoi@chonnam.ac.kr
²Department of Pediatrics, Seonam University Hospital, Gwangju, Korea.

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Abstract

PURPOSE
This study was performed to determine the rate of neonatal symptomatic spontaneous pneumothorax, and the corresponding clinical characteristics, co-morbidities, and outcomes.
METHODS
The demographic characteristics, clinical symptoms and signs, associated abnormalities, methods of treatment, and outcomes were investigated in 22 neonates with symptomatic spontaneous pneumothorax in the neonatal intensive care unit (NICU) of Chonnam University Hospital between March 2003 and February 2008.
RESULTS
The rate of spontaneous pneumothorax was 0.55%. Among the 22 neonates, the number of outborns was 15 (68.2%) and the number of males was 12 (54.5%). The main symptoms and signs were chest retraction, tachypnea, and cyanosis. The pneumothoraces were more frequent on the right side (59.1%) and all cases were diagnosed within 3 days of life. Four cases (18.2%) had urologic abnormalities and 7 cases (31.8%) had cranial abnormalities by ultrasonography. The treatments included oxygen (81.8%) and oxygen with chest tube drainage (18.2%). All of the infants survived and the overall outcomes were favorable.
CONCLUSION
When respiratory symptoms and signs are develop abruptly in otherwise healthy newborns, the clinician should suspect a spontaneous pneumothorax and check a chest x-ray as soon as possible. Although the outcome of neonatal symptomatic spontaneous pneumothorax is favorable, renal and cranial ultrasonography are needed because of the higher possibility of urologic abnormalities and germinal matrix/intraventricular hemorrhage than in newborns without a pneumothorax.

Key Words: Neonate; Spontaneous pneumothorax; Urologic abnormality; Intraventricular hemorrhage; Ultrasonography