Expectant Management of Pneumothorax in Preterm Infants Receiving Assisted Ventilation: Report of 4 Cases and Review of the Literature

• Published in: Respiratory care Vol. 57; no. 5; pp. 789 - 793
• Main Authors: KITSOMMART, Ratchada, MARTINS, Bianca, BOTTINO, Marcela N, SANT'ANNA, Guilherme M
• Format: Journal Article
• Language: English
• Published: Irving, TX Daedalus 01.05.2012; Daedalus Enterprises, Inc
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Artificial respiration; Biological and medical sciences; Care and treatment; Case studies; Emergency and intensive respiratory care; Female; Health aspects; Humans; Infant, Newborn; Infant, Premature; Infants (Premature); Intensive care medicine; Male; Medical sciences; Pneumothorax; Pneumothorax - diagnosis; Pneumothorax - etiology; Pneumothorax - therapy; Respiration, Artificial - adverse effects; Respiratory Distress Syndrome, Newborn - complications; Respiratory Distress Syndrome, Newborn - diagnosis; Respiratory Distress Syndrome, Newborn - therapy; Canada; Premature; Pneumothorax; Intensive care; Assisted ventilation; chest drainage; Effusion; Respiratory disease; preterm; thoracostomy; Drainage; Case study; Clinical management; Prematurity; Bypass; Pleural disease; Resuscitation
• ISSN: 0020-1324; 1943-3654
• DOI: 10.4187/respcare.01446

Pneumothorax is a common complication in infants receiving assisted ventilation. The appropriate management of this condition is not always clearly defined, especially when a large air leak and mediastinal shift are present but the infant is hemodynamically stable. Despite the complications associated with chest tube placement, this remains the most common approach in such cases. We report 4 cases of preterm infants who developed large pneumothoraces with mediastinal shift while on assisted ventilation and were managed conservatively, with substantial improvement within 12-96 hours. In this report we also review the literature on pneumothorax in preterm infants.