ABSTRACT
The purpose of this observational study was to characterize the clinical course of
newborn infants with spontaneous pneumothorax and to identify those infants who eventually
required further interventions. We performed a retrospective review of newborns with
symptomatic spontaneous pneumothorax, born between January 2002 and December 2007.
Seventy-six infants ≥36 weeks' gestation were identified with symptomatic spontaneous
pneumothorax. Twenty-two (29%) of the 76 infants with spontaneous pneumothorax required
either thoracentesis or/and thoracostomy drainage, and 54 (71%) were managed without
such intervention. In all, 18 (24%) infants received mechanical ventilation and 12
(16%) infants developed persistent pulmonary hypertension (PPHN) during the course
of illness. Ten of the 22 infants requiring thoracentesis and/or thoracostomy for
progressively worsening respiratory distress developed PPHN. Seven of these 10 infants
with PPHN received inhaled nitric oxide, and four infants subsequently required extracorporeal
membrane oxygenation. In contrast, the majority of the infants (50 of 54, 93%) not
requiring thoracentesis or/and thoracostomy could be managed simply with supplemental
oxygen or close observation. Progressively worsening respiratory distress prompting
intervention in infants with spontaneous pneumothorax may indicate presence of PPHN
that needs prompt recognition and referral to tertiary-level neonatal units for escalating
respiratory support.
KEYWORDS
Spontaneous pneumothorax - thoracentesis - thoracostomy - persistent pulmonary hypertension
- term and late-preterm infants
REFERENCES
subratas@med.umich.edu
