Characteristics of Pneumothorax in a Neonatal Intensive Care Unit.

Lim,  Ho Seop; Kim,  Ho; Jin,  Jang Yong; Shin,  Young Lim; Park,  Jae Ock; Kim,  Chang Hwi; Kim,  Sung Shin

doi:2011.18.2.257

Neonatal Med > Volume 18(2); 2011 > Article

Original Article

Journal of the Korean Society of Neonatology 2011;18(2):257-264.
DOI: https://doi.org/10.5385/jksn.2011.18.2.257 Published online November 25, 2011.

Characteristics of Pneumothorax in a Neonatal Intensive Care Unit.

Ho Seop Lim, Ho Kim, Jang Yong Jin, Young Lim Shin, Jae Ock Park, Chang Hwi Kim, Sung Shin Kim

Department of Pediatrics, College of Medicine, Soonchunhyang University, Bucheon, Korea. kimss@schmc.ac.kr

Abstract

PURPOSE
The development of postnatal pneumothorax and its common causes and clinical aspects were studied to promote early diagnosis and proper management.
METHODS
A retrospective study of neonates who were hospitalized in the neonatal intensive care unit at Soonchunhyang University Bucheon Hospital from 2001 to 2010 was performed. Term neonates were divided into a spontaneous pneumothorax group and a secondary pneumothorax group. The secondary group was divided into term and preterm groups.
RESULTS
Of 4,414 inpatients, 57 (1.3%) were diagnosed with pneumothorax. Of term newborn patients, 28 (80%) had a secondary pneumothorax, and seven (20%) had a spontaneous pneumothorax. No differences were observed for gender, birth weight, resuscitation, or duration of admission between the spontaneous and control groups. The duration of treatment with a thoracostomy (20 patients, 57%) was longer in the spontaneous group (5.4+/-2.9 days vs. 2.7+/-2.0 days) than that in the control group. Patients with respiratory distress syndrome (RDS) developed a pneumothorax 22.8 hours after surfactant treatment, whereas patients with transient tachypnea of the newborn (TTN), pneumonia, and meconium aspiration syndrome (MAS) developed pneumothorax after 16.6 hours. Of 50 patients with a secondary pneumothorax, 19 (38%) had RDS, 11 (22%) had MAS, 7 (14%) had TTN, and six (12%) had pneumonia. Among term newborns, 42.9% were treated only with 100% oxygen. Among preterm newborns, 72.6% and 27.3% needed a thoracostomy or ventilator care, respectively.
CONCLUSION
A pneumothorax is likely to develop when pulmonary disease occurs in neonates. Therefore, it is important to carefully identify pneumothorax and provide appropriate treatment.

Key Words: Pneumothorax; Neonate; Respiratory distress syndrome; Meconium aspiration syndrome