Clinical Characteristics of Cases Developing Neonatal Pneumothorax: 10 Years of Experience

Year 2025, Volume: 7 Issue: 1, 21 - 24

Fatih Kurt , Abdulkadir Kaya , Kenan Kocabay , Murat Kaya

https://doi.org/10.37990/medr.1540795

Abstract

Aim: Pneumothorax is a serious emergency condition that increases mortality and morbidity due to the accumulation of air between the visceral and parietal pleura layers. Neonatal pneumothorax is more frequently encountered in neonates admitted to neonatal intensive care units. It is known that the most important risk factors are prematurity and ventilation with a bag mask.
Material and Method: Forty-two pneumothorax cases followed in the neonatal intensive care unit (NICU) were included in our study. The characteristics, risk factors, treatment methods and prognoses of the cases were retrospectively analyzed.
Results: Twenty eight of the cases (66.67%) were male, and Pneumothorax developed within the first 3 days of life in 41 cases (97.61%). Nineteen cases (45.24%) were premature, 16 cases (38.10%) underwent resuscitation at birth, and 15 cases (35.71%) received surfactant therapy. An intercostal chest tube was placed for treatment in 34 cases (80.95%), and invasive mechanical ventilation was required in 33 cases (78.57%). Thirty six cases (85.71%) were regained the health, while those who passed away were found to be more premature.
Conclusion: In our study, prematurity, resuscitation at birth, and surfactant therapy were identified as risk factors for neonatal pneumothorax. Newborns with these risk factors should be closely monitored, and neonatal pneumothorax should be kept in mind if respiratory distress develops.

Keywords

Neonatal pneumothorax, prematurity, resuscitation

Ethical Statement

Duzce University Faculty of Medicine Ethics Committee (Decision no:2024/94, Approval Date:06.05.2024)

References

• Joshi A, Kumar M, Rebekah G, Santhanam S. Etiology, clinical profile and outcome of neonatal pneumothorax in tertiary care center in South India: 13 years experience. J Matern Fetal Neonatal Med. 2022;35:520-4.
• Parekh UR, Maguire AM, Emery J, Martin PH. Pneumothorax in neonates: complication during endotracheal intubation, diagnosis, and management. J Anaesthesiol Clin Pharmacol. 2016;32:397-9.
• Halibullah I, Hammond F, Hodgson K, et al. Management of pneumothorax in neonatal retrieval: a retrospective cohort study. Arch Dis Child Fetal Neonatal Ed. 2023;108:182-7.
• Al Matary A, Munshi HH, Abozaid S, et al. Characteristics of neonatal pneumothorax in Saudi Arabia: three years' experience. Oman Med J. 2017;32:135-9.
• Jhaveri V, Vali P, Giusto E, et al. Pneumothorax in a term newborn. J Perinatol. 2024;44:465-71.
• Fei Q, Lin Y, Yuan TM. Lung ultrasound, a better choice for neonatal pneumothorax: a systematic review and meta-analysis. Ultrasound Med Biol. 2021;47:359-69.
• Panza R, Prontera G, Ives KN, et al. Pigtail catheters versus traditional chest drains for pneumothorax treatment in two NICUs. Eur J Pediatr. 2020;179:73-9.
• Ayşe Tandırcıoğlu Ü, Koral Ü, Güzoğlu N, et al. Differences in possible risk factors, treatment strategies, and outcomes of neonatal pneumothorax in preterm and term infants. Turk Arch Pediatr. 2024;59:87-92.
• Jovandaric MZ, Milenkovic SJ, Dotlic J, et al. Neonatal pneumothorax outcome in preterm and term newborns. Medicina (Kaunas). 2022;58:965.
• Ishak N, Hanita T, Sozo F, et al. Sex differences in cardiorespiratory transition and surfactant composition following preterm birth in sheep. Am J Physiol Regul Integr Comp Physiol. 2012;303:R778-89.
• 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.
• Boo NY, Cheah IGS, Malaysian National Neonatal Registry. Risk factors associated with pneumothorax in Malaysian neonatal intensive care units. J Paediatr Child Health. 2011;47:183-90.
• Smith J, Schumacher RE, Donn SM, Sarkar S. Clinical course of symptomatic spontaneous pneumothorax in term and late preterm newborns: report from a large cohort. Am J Perinatol. 2011;28:163-8.
• Okumuş M, Zubarioğlu AU. Neonatal pneumothorax-10 years of experience from a single center. J Pediatr Res. 2020;7:163-7.
• Bhatia R, Davis PG, Doyle LW, et al. Identification of pneumothorax in very preterm infants. J Pediatr. 2011;159:115-20.
• Apiliogullari B, Sunam GS, Ceran S, Koc H. Evaluation of neonatal pneumothorax. J Int Med Res. 2011;39:2436-40.
• Andersson J, Magnuson A, Ohlin A. Neonatal pneumothorax: symptoms, signs and timing of onset in the post-surfactant era. J Matern Fetal Neonatal Med. 2022;35:5438-42.