Abstract
Background: Pneumothorax is a common complication in the premature newborn with respiratory distress syndrome. Its incidence may have declined following the widespread use of antenatal steroids and surfactant. However clinicians are concerned that use of CPAP may be associated with increases risk of Pneumothorax.
Aim: To describe the demographic profile of a cohort of premature infants with pneumothorax.
Method: Regional tertiary neonatal centre in the north east of England. All newborns with pneumothorax or other air leak syndromes over 10 year period were included. Variables recorded; gestation, antenatal steroids, surfactant use and non-invasive respiratory support (CPAP).
Results: 3804 admissions, 107 infants were diagnosed with pneumothorax or other air leak syndrome (overall incidence of 2.8%). This included 72 premature infants of whom 37 were under 28 weeks gestation. The incidence of pneumothorax and pulmonary interstitial emphysema (PIE) was 2.3% and 0.47% respectively. There was statistically significant association between the severity of pneumothorax and degree of prematurity, use of surfactant and CPAP. Severe pneumothorax requiring drainage was more in extremely premature infants who didn't received optimal dose of surfactant. No statistically significant effect was noted with variables such as lack of antenatal steroids, gender, mode of delivery, use of muscle relaxants and squad retrievals.
Conclusion: Incidence of pneumothorax and other air leak syndromes was lower compared with other cohort studies. Risk of pneumothorax was increased with use of CPAP and suboptimal surfactant dose. Effect of CPAP in extreme premature newborns without antenatal steroids and postnatal surfactant exposure require further evaluation.
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Ali, H., Esampalli, S., Aldridge, L. et al. 1231 Pneumothorax and Air Leak Syndromes in the Newborn, a Cohort Study. Pediatr Res 68 (Suppl 1), 610 (2010). https://doi.org/10.1203/00006450-201011001-01231
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DOI: https://doi.org/10.1203/00006450-201011001-01231