Clinical analysis of neonatal pneumothorax

Sakamoto Jin, Kosaka Shinji, Hijiya Kyoko

doi:10.2995/jacsurg.23.928

We reviewed 50 neonates with pneumothorax whom we managed at our hospital from March 1999 to September 2008. There were 33 males and 17 females. There were 14 neonates with left pneumothorax, 23 with right pneumothorax, and 13 with bilateral involvement. They included 2 extremely low birth weight infants, 3 very low birth weight infants, 10 low birth weight infants, and 1 giant infant. There were 15 preterm, 35 term, and no postterm infants. Thirty-one infants developed pneumothorax on the day of delivery, which was the most frequent day of onset. The underlying diseases were meconium aspiration syndrome in 17 infants, respiratory distress syndrome in 13, transient tachypnea of the newborn in 12, and pulmonary hypoplasia in 4. Ventilation was being performed in 24 infants before the onset. The treatment included a thoracic tube in 13 infants (bilateral in 2), thoracocentesis in 2, and high concentration oxygen therapy in 4. The course was favorable in 46 infants, but 4 infants died. The 30 infants with a thoracic tube included 10 preterm infants and 12 who were on ventilation before the onset, and the incidence was significantly higher in these infants than in term infants and infants who were not on ventilation. Among the 4 infants who died, 3 were preterm and all 4 were on ventilation before the onset. All of the infants who died had underlying lung diseases. We conclude that thoracic drainage must be considered actively when neonatal pneumothorax occurs in preterm infants or those on ventilation before onset.

Clinical analysis of neonatal pneumothorax

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