Association of delayed initiation of non-invasive respiratory support with pulmonary air leakage in outborn late-preterm and term neonates

Incidence of ultrasonographic signs of pneumothorax in asymptomatic neonates

“…Although in the analysis of risk factors we found a significantly higher proportion of instrumental deliveries or cesarean sections in patients in Group A, the differences in terms of administration of positive pressure at birth (IPPV or CPAP) were not significant. These results also contrast with those in the literature, [6][7][8]19 but agree with those of a recent publication by our group. 18 However, in this study we could not determine if the pneumothorax was present at birth or before IPPV or CPAP initiation.…”

“…Preterm newborns, being a neonatal population with a higher frequency of pulmonary disease, have a higher incidence of pneumothorax 1,4 . Some studies suggest that the administration of intermittent positive pressure ventilation (IPPV) during resuscitation maneuvers at birth or the application of continuous positive airway pressure (CPAP) in newborns with respiratory distress are risk factors for the development of pneumothorax 6–8 . However, often it is not possible to determine if the pneumothorax was present before CPAP initiation.…”

“…Some studies suggest that the administration of intermittent positive pressure ventilation (IPPV) during resuscitation maneuvers at birth or the application of continuous positive airway pressure (CPAP) in newborns with respiratory distress are risk factors for the development of pneumothorax. [6][7][8] However, often it is not possible to determine if the pneumothorax was present before CPAP initiation. Newborns with spontaneous pneumothorax at birth usually present symptoms of respiratory distress, although if the air leak is small it can go unnoticed on chest X-rays and if the newborn remains asymptomatic.…”