Am J Perinatol 2011; 28(2): 163-168
DOI: 10.1055/s-0030-1263300
© Thieme Medical Publishers

Clinical Course of Symptomatic Spontaneous Pneumothorax in Term and Late Preterm Newborns: Report from a Large Cohort

Joann Smith1 , Robert E. Schumacher1 , Steven M. Donn1 , Subrata Sarkar1
  • 1Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Michigan Health System, C. S. Mott Children's Hospital, Ann Arbor, Michigan
Further Information

Publication History

Publication Date:
10 August 2010 (online)

Preview

ABSTRACT

The purpose of this observational study was to characterize the clinical course of newborn infants with spontaneous pneumothorax and to identify those infants who eventually required further interventions. We performed a retrospective review of newborns with symptomatic spontaneous pneumothorax, born between January 2002 and December 2007. Seventy-six infants ≥36 weeks' gestation were identified with symptomatic spontaneous pneumothorax. Twenty-two (29%) of the 76 infants with spontaneous pneumothorax required either thoracentesis or/and thoracostomy drainage, and 54 (71%) were managed without such intervention. In all, 18 (24%) infants received mechanical ventilation and 12 (16%) infants developed persistent pulmonary hypertension (PPHN) during the course of illness. Ten of the 22 infants requiring thoracentesis and/or thoracostomy for progressively worsening respiratory distress developed PPHN. Seven of these 10 infants with PPHN received inhaled nitric oxide, and four infants subsequently required extracorporeal membrane oxygenation. In contrast, the majority of the infants (50 of 54, 93%) not requiring thoracentesis or/and thoracostomy could be managed simply with supplemental oxygen or close observation. Progressively worsening respiratory distress prompting intervention in infants with spontaneous pneumothorax may indicate presence of PPHN that needs prompt recognition and referral to tertiary-level neonatal units for escalating respiratory support.

REFERENCES

Subrata SarkarM.D. 

Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Michigan Health System

F5790 C.S. Mott Children's Hospital, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0254

Email: subratas@med.umich.edu