Abstract

Objective: Pneumothorax, an important cause of morbidity and mortality especially premature infants, develops most commanly in the neonatal period during childhood. Our aim is to evaluate newborns diagnosed with pneumothorax in our unit.

Material and Methods: The records of newborn babies who were diagnosed as pneumothorax in the Neonatal Intensive  Care  Unit  of  Zekai  Tahir  Burak  Women’s  Health  Education  and  Research  Hospital  between  January  1, 2015 and December 31, 2015 were analyzed retrospectively. Newborn infants who were diagnosed radiologically as pneumothorax were included in the study. Major congenital anomalies were excluded from the study.

Results: The incidence of pneumothorax was 0.4% in all live births and 2.6% in the neonatal intensive care unit. The mean gestation age of the babies was 34.2 ± 3.6 weeks and birth weight was 2322 ± 841 gr. Of the 67 newborns with pneumothorax, 49 were male (73.1%), and 59 (88.1%) were born by cesarean section. transient tachypnea of the newborn (38.8%) and Respiratory distress syndrome (31.3%) were the most common underlying pulmonary diseases in infants who developed pneumothorax. For the treatment of pneumothorax, 50 (74.7%) babies were treated with chest tube and 17 (25.3%) had no chest tube. Gestational age and birth weight were significantly lower in the drainage group (p <0.05). The duration of mecharinical ventilation and non-invasive respiratory support was significantly longer in the drainage group, but the free oxygen requirement was longer, but there was no significant difference. There was no difference between the two groups in terms of preterm morbidity and mortality.

Conclusion: In the neonatal period, pneumothorax is frequently encountered and usually within the first two days. The most common underlying lung disease in premature infants is RDS, while term infants is TTN. About ¾ of newborns developing pneumothorax should be treated by inserting a chest tube. In case of pneumothorax development in infants with gestational age of <32 weeks, a chest tube should be inserted in almost all of them. In infants who in need drainage, the duration of invasive and noninvasive respiratory support and the time of hospitalization are significantly longer.

Keywords: Pneumothorax, incidence, drainage

References

  1. Hermansen CL, Lorah KN. Respiratory distress in the newborn. Am Fam Physician 2007;76:987–94.
  2. Horbar JD, Badger GJ, Carpenter JH, Fanaroff AA, Kilpatrick S, LaCorte M, et al. Trends in mortality and morbidity for very low birth weight infants, 1991–1999. Pediatrics 2002;110:143–51.
  3. Aly H, Massaro A, Acun C, Ozen M. Pneumothorax in the newborn: clinical presentation, risk factors and outcomes. J Matern Fetal Neonatal Med. 2014;27:402–6.
  4. Ogata ES, Gregory GA, Kitterman JA, Phibbs RH, Tooley WH. Pneumothorax in the respiratory distress syndrome: incidence and effect on vital signs, blood gases, and pH. Pediatrics 1976;58:177–83.
  5. Goldberg RN, Abdenour GE. Air leak syndrome. In: Spitzer AR, ed. Intensive care of the fetus and neonate. St. Louis, MO: Mosby- Yearbook; 1996:629–40.
  6. Vibede L, Vibede E, Bendtsen M, Pedersen L, Ebbesen F. Neonatal Pneumothorax: A Descriptive Regional Danish Study. Neonatology. 2017;111:303–308.
  7. Watkinson M, Tiron I. Events before the diagnosis of a pneumothorax in ventilated neonates. Arch Dis Fetal Neonatal Ed 2001;85: F201–3.
  8. Miller JD, Carlo WA. Pulmonary complications of mechanical ventilation in neonates. Clin Perinatol. 2008;35:273–81.
  9. Trevisanuto D, Doglioni N, Ferrarese P, Vedovato S, Cosmi E, Zanardo V: Neonatal pneumothorax: comparison between neonatal transfers and inborn infants. J Perinat Med 2005;33:449–54.
  10. Katar S, Devecioğlu C, Kervancioğlu M, Ulkü R: Symptomatic spontaneous pneumothorax in term newborns. Pediatr Surg Int 2006;22:755–758.
  11. Esme H, Doğru O, Eren S, Korkmaz M, Solak O: The factors affecting persistent pneumothorax and mortality in neonatal pneumothorax. Turk J Pediatr 2008; 50: 242–6.
  12. Benterud T, Sandvik L, Lindemann R: Cesarean section is associated with more frequent pneumothorax and respiratory problems in the neonate. Acta Obstet Gynecol Scand 2009;88: 359–61.
  13. Apiliogullari B, Sunam GS, Ceran S, Koc H. Evaluation of neonatal pneumothorax. J Int Med Res 2011;39:2436–40.
  14. Çördük N, Ürey T, Küçüktaşçı K, Özdemir ÖMA, Herek Ö, Büke AS, et al. Yenidoğan pnömotorakslı olguların değerlendirilmesi. Pam Tıp Derg 2014;7:47–51.
  15. Tudehop DI, Smyth MH: Is ‘transient tachypnoea of the newborn’ always a benign disease? Aust Paediatr J 1979;15:160–5.
  16. Reynolds EO: Hyaline membrane disease. Am J Obs Gynecol 1970;106: 780–94.
  17. Kolås T, Saugstad OD, Daltveit AK, Nilsen ST, Øian P: Planned cesarean versus planned vaginal delivery at term: comparison of newborn infant outcomes. Am J Obstet Gynecol 2006;195:1538–43.
  18. Cizmeci MN, Kanburoglu MK, Akelma AZ, Andan H, Akin K, Tatli MM. An abrupt increment in the respiratory rate is a sign of neonatal pneumothorax. J Matern Fetal Neonatal Med 2015;28:583–7.
  19. Özbek AS, Kavuncuoğlu S, Ugan Atik S, Aldemir EY, Payaslı M, Sander S. 2004-2008 Yılları arasında yenidoğan yoğun bakım ünitesinde pnömotoraks tanısıyla izlenen olguların incelenmesi. JOPP Derg 2011;3:79–85.
  20. Bhatia R, Davis PG, Doyle LW, Wong C, Morley CJ: Identification of pneumothorax in very preterm infants. J Pediatr 2011;159:115–120.e1.
  21. Zenciroglu A, Aydemir C, Bas AY, Demirel N. Evaluation of predisposing and prognostic factors in neonatal pneumothorax cases. Tuberk Toraks 2006;54:152–6.
  22. Bhat Yellanthoor R, Ramdas V. Frequency and intensive care related risk factors of pneumothorax in ventilated neonates. Pulm Med 2014;2014:727323.
  23. Klinger G, Ish-Hurwitz S, Osovsky M, Sirota L, Linder N. Risk factors for pneumothorax in very low birth weight infants. Pediatr Crit Care Med. 2008;9:398–402.
  24. Morley CJ, Davis PG, Doyle LW, Brion LP, Hascoet JM, Carlin JB, et al. Nasal CPAP or intubation at birth for very preterm infants. N Engl J Med 2008;358:700–8.
  25. Finer NN, Carlo WA, Walsh MC, Rich W, Gantz MG, Laptook AR, et al.; SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network. Early CPAP versus surfactant in extremely preterm infants. N Engl J Med 2010;362:1970–9.
  26. Geary C, Caskey M, Fonseca R, Malloy M. Decreased incidence of bronchopulmonary dysplasia after early management changes, including surfactant and nasal continuous positive airway pressure treatment at delivery, lowered oxygen saturation goals, and early amino acid administration: a historical cohort study. Pediatrics 2008;121:89–96.

Copyright and license

Copyright © 2019 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Büyüktiryaki M, Alyamaç Dizdar E, Okur N, Özer Bekmez B, Tayman C. PNEUMOTHORAX IN NEWBORN AND COMPARISON OF DEMOGRAPHIC AND CLINICAL FEATURES ACCORDING TO DRAINAGE TREATMENT REQUIREMENT WITH CHEST TUBE. Turk J Pediatr Dis [Internet]. 2019 Mar. 26 [cited 2025 Aug. 23];13(2):50-6. Available from: https://turkjpediatrdis.org/article/view/619