Risk factor analysis of pneumothorax associated with persistent pulmonary hypertension of the newborn in Thai neonates

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

“…In addition, lung US (LUS) performed on asymptomatic term infants show that the incidence of mild PTX in these patients can be as high as 10% 2,3 . Risk factors associated with increased incidence of PTX include meconium aspiration syndrome (MAS), respiratory distress syndrome (RDS), and persistent pulmonary hypertension of the newborn (PPHN) 4,5,6,7 . A 1 min Apgar score ≤ 7 was associated with a 2.67x increased risk of PTX (95% CI 1.14-6.25) 8 .…”

“…The incidence of PTX in infants with a <2,500 g birth weight (BW) increases almost 10x compared to those with a BW ≥ 2500 g 8 . Notably, PTX is associated with increased mortality, with an odds ratio of 5.27 (95% CI = 1.96-14.17) 7 . Apiliogullari et al reported that aggregate mortality was as high as 30% in PTX patients while survivors also had an increased rate of bronchopulmonary dysplasia (4.28x vs. controls) 9 .…”

“…Apiliogullari et al reported that aggregate mortality was as high as 30% in PTX patients while survivors also had an increased rate of bronchopulmonary dysplasia (4.28x vs. controls) 9 . Therefore, early and accurate diagnosis followed by adequate treatment is imperative 3,4,5,6,7,8,9,10,11,12,13,14 . Lately, less expensive US imaging systems have become readily available, and non-ionizing, fast, and repeatable LUS represents an ideal tool for the diagnosis of neonatal PTX.…”

Case Report: Neonatal Massive Pneumothorax Resulting in Compression Atelectasis Treated by Ultrasound-Guided Pleural Puncture Therapy: A Typical Case Based on Lung Ultrasound Finding

“…In hospitalized neonates, its incidence increased to 4.5% ( 9 ), an eight-fold increase. Moreover, PTX causes a 5.27-fold (95% CI = 1.96–14.17) increase in mortality ( 10 ), while the incidence of BPD increases 4.28-fold in survivors ( 11 ). Therefore, neonatologists have always been highly concerned about the diagnosis and treatment of PTX.…”

Precordial Heart Image Disappearance: An Uncommon New Specific Ultrasound Sign for Diagnosing Neonatal Pneumothorax and its Thoracentesis Treatment at the Precardiac Area- an Pilot Study Reports from Two Centers

“…Pneumothorax (PTX) occurs when gas accumulates in the pleural space.PTX is one of the common complications of neonatal pulmonary disease,and it leads to a signi cant increase in neonatal mortality.A retrospective survey from Canada on 71,237 newborn infants indicated that the neonatal population incidence rate of PTX was 4.0% in early preterm (gestational age [GA] < 32 weeks),2.6% in moderate-late preterm (GA 32-36 weeks),and 6.7% in term (GA ≥ 37 weeks) neonates [1].Another investigation from the US showed that in 13,811 newborn infants,the prevalence of PTX was 0.27% in infants with a birth weight of < 2500 g and 2.5% in infants with a birth weight of ≥ 2500 g [2].PTX is not only associated with a 30% increase in mortality with an odds ratio of 5.27 (95% con dence interval 1.96-14.17) [3,4],but it is also associated with a high rate of bronchopulmonary dysplasia,severe intraventricular hemorrhage,and a prolonged neonatal intensive care unit (NICU) length of stay,especially in early preterm neonates [1][2][3][4].Therefore,early and accurate diagnosis followed by correct treatment is imperative to improve the prognosis of patients with PTX.…”