Predictors of chest drainage of pneumothorax in neonates

Abstract

This is a retrospective, single-center observational study to explore the predictors of chest drainage for neonatal pneumothorax. A total of 183 neonates (age p28 days) who presented to the Children's Hospital of Soochow University between January 1, 2015 and December 31, 2018 for pneumothorax or developed pneumothorax during a hospital stay were included. Demographic data, clinical presentation, and imaging characteristics of neonatal pneumothorax were collected and analyzed. We used univariate and multivariate logistic regression analyses to determine significant predictors of chest drainage of pneumothorax in neonates. Pneumothorax occurred within 24 h after birth in 131 (71.6%) cases, between 24 and 48 h after birth in 41 (22.4%) cases, and 48 h after birth in 11 (6.0%) cases. Univariate and multivariate logistic regression analyses revealed that lung collapse X1/3 on initial chest X-ray (OR 4.99, 95%CI 2.25-11.07), chest retractions (OR 8.12, 95%CI 2.88-22.89), cyanosis (OR 2.25, 95%CI 1.08-4.66), and frothing from mouth (OR 2.49, 95%CI 1.12-5.49) (Po0.05 for all) were significant predictors of the need for chest drainage due to pneumothorax. In conclusion, the thorough evaluation of the above predictive factors can guide treatment and improve patient outcome.

Neonatal Pneumothorax- Five Years of Experience in a Tertiary Care Center

“…Pneumothorax is more common in preterm infants (34.62 +/-4 GW), as shown by the results of other studies [10,11,24], although there are authors who found more children born at term with NP [6]. In our study, the percentage of LGA (21.6%) among neonates with NP was slightly higher compared to the general population.…”

“…The risk of developing pneumothorax is increased in neonates with respiratory distress syndrome (RDS), meconium aspiration syndrome (SAM), transient neonatal tachypnea (TTN), pulmonary hypoplasia, persistent pulmonary hypertension (PPHN), and in neonates with applied resuscitation after birth. Lung disease is the underlying condition in 59-61% of infants with pneumothorax.The association of RDS, pneumonia, TTN and sepsis with NP is also significant in our neonates [10,11,24], although MAS is not represented in our results in a high percentage as in the mentioned studies. The low APGAR score in the 5th minute and resuscitation at birth is an important factor in the development of NP, as shown by other authors [7,11,24].…”

“…In our study, the percentage of LGA (21.6%) among neonates with NP was slightly higher compared to the general population. As shown by other authors, NP is more common in infants born by caesarian section [10,24].…”

“…Among neonates born by CS at term or moderately prematurely (30 -36 weeks), the incidence of NP and respiratory problems is significantly increased. These problems can be avoided by postponing childbirth and administering antenatal steroid therapy where appropriate and possible [24].…”

Pneumothorax in Children

“…Although thoracic injuries occur less frequently in children than adults, thoracic trauma in children carries a 5% mortality [20,21]. The most causes of trauma in pediatric patients are traffic accidents, followed by falling from heights, and bicycle accidents [22].…”