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Yenidoğanda Pnömotoraks ve Göğüs Tüpü Uygulamaları

Year 2020, Volume: 10 Issue: 1, 75 - 81, 31.03.2020
https://doi.org/10.16899/jcm.672424

Abstract

Amaç: Pnömotoraks, yenidoğan döneminde hayatın diğer dönemlerine göre daha sık görülür ve acil müdahale gerektiren bir durumdur. Pnömotoraks tedavisinde göğüs tüpü yerleştirilmesi tek ve geçerli tedavi şekli olma özelliğini sürdürmektedir. Bu çalışma; pnömotoraks nedeniyle göğüs tüpü uygulaması yapılmış yenidoğanlarda retrospektif olarak planlanmıştır. Klinik bulgular ve demografik karakteristikler, teknik özellikler, komplikasyonlar araştırılmış ve bunların tanı ve tedaviyi nasıl yönlendirdiği incelenmiştir.
Gereç ve Yöntem: Üç senelik periyot içerisinde yenidoğan yoğun bakıma yatan pnömotoraks gelişmiş bebeklerde; gebelik haftaları, doğum şekli, ağırlık, boy, yatış tanıları, pnömotoraks öncesi, pnömotoraks anı ve sonrasındaki solunum durumları, pnömotoraks gelişiminin olduğu taraf, tüpün konulması, tüp kalış süresi, hastanede kalış süresi, kan, idrar, göğüs tüpünün uç kısmının kültürü, trakeal tüp kültürleri, nekrotizan enterokolit gelişimi, şifa durumları, takip süreleri ve bu takip sürelerinde oluşan akciğer patolojileri kaydedildi.
Bulgular: Bebeklerin pnömotorakstan şifa durumlarını doğum şekli, ağırlık, boy, pnömotoraksın geliştiği taraf, tüpün konulduğu taraf, tüpün konulduğu anki bebeğin yaşı, tüp kalış süresi etkilememektedir. Pnömotoraks öncesi, pnömotoraks anındaki ve sonrasındaki solunum durumları önemlidir. Altta yatan akciğer patolojisi prognozu etkilemektedir.
Erken tanı için röntgen grafilerindeki medial radyolüsen alanlar ve loküle radyolüsen alanlar dikkati çekmektedir.
Sonuç: Pnömotoraks mortalitesini ve morbiditesini azaltmada yenidoğan yoğun bakım ünitesindeki bebekler vital bulgular ve radyografik işaretler açısından yakından takip edilmeli, bebekte stabiliteyi bozan durumlarda acil göğüs tüpü yerleştirilmelidir. Klinik durumu bozmayan minimal pnömotorakslar göğüs tüpü konulmadan yakından izlenmelidir. 

References

  • Referans1. Devleta Hadzic,Fahrija Skokic,Edin Husaric,Hajriz Alihodzic,Dzenana Softic,Dzenita Kovacevic. Risk Factors and Outcome of Neonatal Pneumothorax in Tuzla Canton. Mater Sociomed. 2019 Mar; 31(1):66-70 Referans2. Mayo P,Saha SP. Spontaneous Pneumothorax in the newborn.Am Surg 49:192, 1983. Referans3. Cheng CY,Soong WJ. Local interstitial emphysema caused by meconium aspiration: report of one case. Acta Paediatr Taiwan 42(4): 236-8,2001 Referans4. Maksic H,Heljic S,Maksic S,Jonuzi F. Pulmonary complications during mechanical ventilation in the neonatal period. Med Arh 54(5-6): 271-2,2000 Referans5. McIntosh N,Becher JC,Cunningham S,Stenson B,Laing IA,Lyon AJ, Badger P. Clinical diagnosis of pneumothorax is late: use of trend data and excision support might allow preclinical detection. Pediatr Res Sep; 48(3): 408-415,2000 Referans6.Vibede L,Vibede E,Bendtsen M,Pedersen L,Ebbesen F. Neonatal Pneumothorax:A Descriptive Regional Danish Study. Neonatology;111:303-308.2017 Referans7. Bhat Yellanthoor R,Ramdas V. Frequency and intensive care related risk factors of pneumothorax in ventilated neonates. Pulm Med; 2014: 727-732.2014 Referans8. Esme H,Dogru O,Eren S, et al. The factors affecting persistent pneumothorax and mortality in neonatal pneumothorax.Turk J Pediatr;50(3):242-246.2008 Referans9. Jones RM,Rutter N, Cooper AC,Pullan CR. Pneumothox in neonatal period. Anaesthesia, 38: 948,1983. Referans10. Yu VYH,Wong PY, Szymonowic W. Pulmonary air leak in extremely low birth weight infants. Arch Dis Child 6 (3):239-41,1986 Referans11. Hakkinen PJ,Morse CC,Martin FM, et al. Potentiating effects of oxygen in lungs damaged by methylcyclopentadienyl manganese tricarbonyl, cadmium chloride, oleic acid, and antitumor drugs.Toxicol Appl Pharmacol 67:55-69,1983 Referans12. Ryan CA,Barrington KJ, Philips HJ, Finer NN. Contralateral pneumothoraces in the newborn: incidence and predisposing factors. Pediatrics Mar; 79 (3): 417-21,1987. Referans13. Aly H, Massaro A, Acun C, Ozen M. Pneumothorax in the newborn: clinical presentation, risk factors and outcomes. J Matern Fetal Neonatal Med.; 27(4):402-406.2014 Referans14. Greenough A, Morley CJ.Pneumothorax in infants who fight ventilators. Lancet Mar 24: 1(8378):689,1984 Referans15. Anatomi 1. Cilt, Arıncı K, Elhan A. Güneş Kitabevi LTD ŞTİ,1995 Referans16. Garry RF, Ludwig S,Textbook of Pediatric Emergency Medicine, 4th edition, Lippincott William&Wilkins, Philadelphia,2000. Referans17. Temesvari P.,Kovacs J,Abraham CS.Pneumothorax and neonatal stroke. Neuropediatrics Jun;27(3): 167-8,1996. Referans18. Lipscomb AP,Reynolds EOR,Blackwell RJ, et al. Pneumothorax and cerebral hemorrhage in preterm infants. Lancet 8217:414-416,1981 Referans19. Sahn SA,Heffner JE:Spontaneous pneumothorax. NEJM, 23:868,2000. Referans20. Grim III PF,William JK.Two uncommon radiographic signs of an anterior neonatal pneumothorax. Clin Pediatr (Phila) Sep 25(9):440-4,1986 Referans21. Liang JS,Lu FL, Tang JR, Yau KI.Congenital diaphragmatic hernia misdiagnosed as pneumothorax in a newborn.Acta Paediatr Taiwan 41(4):221-3,2000

Pneumothorax in newborn and chest tube application

Year 2020, Volume: 10 Issue: 1, 75 - 81, 31.03.2020
https://doi.org/10.16899/jcm.672424

Abstract

Objective: Pneumothorax, which is more common in the newborn period compared to other periods of life, is a condition that requires urgent intervention. Chest tube placement remains the only and valid treatment for pneumothorax. A retrospective study was performed in terms of guiding the diagnosis and treatment, which can be obtained from technical features, complications, clinical findings, demographic characteristics of chest tube applications.
Materials and Methods: Infants diagnosed with pneumothorax in a 3 - year neonatal intensive care unit were included in this retrospective study. Pregnancy weeks, delivery type, weight, height, hospitalization, respiratory status before and after pneumothorax, side of pneumothorax development, tube placement, length of tube stay, length of hospital stay, blood, urine, chest tube, tracheal tube cultures, necrotizing enterocolitis development, healing conditions, follow-up periods and pulmonary pathologies during these follow-up periods were recorded.
Results: The recovery status of the infants from pneumothorax is not affected by the mode of delivery, weight, height, the side on which the pneumothorax develops, the side on which the tube is placed, the age of the baby on which the tube is placed, and the duration of the tube stay. Pulmonary status before, during and after pneumothorax is important. The underlying lung pathology affects prognosis.
For early diagnosis, medial radiolucent areas and loculated radiolucent areas on radiographs are noteworthy.
Conclusion:, The baby should be closely monitored for vital signs In order to reduce the mortality and morbidity of the pneumothorax and an emergency chest tube should be placed.

References

  • Referans1. Devleta Hadzic,Fahrija Skokic,Edin Husaric,Hajriz Alihodzic,Dzenana Softic,Dzenita Kovacevic. Risk Factors and Outcome of Neonatal Pneumothorax in Tuzla Canton. Mater Sociomed. 2019 Mar; 31(1):66-70 Referans2. Mayo P,Saha SP. Spontaneous Pneumothorax in the newborn.Am Surg 49:192, 1983. Referans3. Cheng CY,Soong WJ. Local interstitial emphysema caused by meconium aspiration: report of one case. Acta Paediatr Taiwan 42(4): 236-8,2001 Referans4. Maksic H,Heljic S,Maksic S,Jonuzi F. Pulmonary complications during mechanical ventilation in the neonatal period. Med Arh 54(5-6): 271-2,2000 Referans5. McIntosh N,Becher JC,Cunningham S,Stenson B,Laing IA,Lyon AJ, Badger P. Clinical diagnosis of pneumothorax is late: use of trend data and excision support might allow preclinical detection. Pediatr Res Sep; 48(3): 408-415,2000 Referans6.Vibede L,Vibede E,Bendtsen M,Pedersen L,Ebbesen F. Neonatal Pneumothorax:A Descriptive Regional Danish Study. Neonatology;111:303-308.2017 Referans7. Bhat Yellanthoor R,Ramdas V. Frequency and intensive care related risk factors of pneumothorax in ventilated neonates. Pulm Med; 2014: 727-732.2014 Referans8. Esme H,Dogru O,Eren S, et al. The factors affecting persistent pneumothorax and mortality in neonatal pneumothorax.Turk J Pediatr;50(3):242-246.2008 Referans9. Jones RM,Rutter N, Cooper AC,Pullan CR. Pneumothox in neonatal period. Anaesthesia, 38: 948,1983. Referans10. Yu VYH,Wong PY, Szymonowic W. Pulmonary air leak in extremely low birth weight infants. Arch Dis Child 6 (3):239-41,1986 Referans11. Hakkinen PJ,Morse CC,Martin FM, et al. Potentiating effects of oxygen in lungs damaged by methylcyclopentadienyl manganese tricarbonyl, cadmium chloride, oleic acid, and antitumor drugs.Toxicol Appl Pharmacol 67:55-69,1983 Referans12. Ryan CA,Barrington KJ, Philips HJ, Finer NN. Contralateral pneumothoraces in the newborn: incidence and predisposing factors. Pediatrics Mar; 79 (3): 417-21,1987. Referans13. Aly H, Massaro A, Acun C, Ozen M. Pneumothorax in the newborn: clinical presentation, risk factors and outcomes. J Matern Fetal Neonatal Med.; 27(4):402-406.2014 Referans14. Greenough A, Morley CJ.Pneumothorax in infants who fight ventilators. Lancet Mar 24: 1(8378):689,1984 Referans15. Anatomi 1. Cilt, Arıncı K, Elhan A. Güneş Kitabevi LTD ŞTİ,1995 Referans16. Garry RF, Ludwig S,Textbook of Pediatric Emergency Medicine, 4th edition, Lippincott William&Wilkins, Philadelphia,2000. Referans17. Temesvari P.,Kovacs J,Abraham CS.Pneumothorax and neonatal stroke. Neuropediatrics Jun;27(3): 167-8,1996. Referans18. Lipscomb AP,Reynolds EOR,Blackwell RJ, et al. Pneumothorax and cerebral hemorrhage in preterm infants. Lancet 8217:414-416,1981 Referans19. Sahn SA,Heffner JE:Spontaneous pneumothorax. NEJM, 23:868,2000. Referans20. Grim III PF,William JK.Two uncommon radiographic signs of an anterior neonatal pneumothorax. Clin Pediatr (Phila) Sep 25(9):440-4,1986 Referans21. Liang JS,Lu FL, Tang JR, Yau KI.Congenital diaphragmatic hernia misdiagnosed as pneumothorax in a newborn.Acta Paediatr Taiwan 41(4):221-3,2000
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Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original Research
Authors

Sabriye Dayı 0000-0002-0643-3785

Fatih Andıran 0000-0002-5628-7384

Publication Date March 31, 2020
Acceptance Date February 23, 2020
Published in Issue Year 2020 Volume: 10 Issue: 1

Cite

AMA Dayı S, Andıran F. Yenidoğanda Pnömotoraks ve Göğüs Tüpü Uygulamaları. J Contemp Med. March 2020;10(1):75-81. doi:10.16899/jcm.672424