Abstract

Aim: This study aimed to retrospectively evaluate the patients who were followed up in the neonatal intensive care unit of our hospital with the diagnosis of pneumothorax.

Methods: The records of patients who were followed up with the diagnosis of pneumothorax in our neonatal intensive care unit between September 1, 2016 and December 31, 2022 were retrospectively reviewed. Birth weight, sex, gestational week, mode of delivery, localization of pneumothorax, presence of underlying primary lung disease, and mortality were evaluated.

Results: The mean birth weight of 35 patients (19 girls, 16 boys) who developed pneumothorax was 2200±1050 g and the mean gestational age was 33.2±5.1 weeks. Twenty-seven of the patients were delivered by cesarean section and 8 by normal spontaneous vaginal delivery. Pneumothorax was most common on the right side (n:19) and no patient had bilateral pneumothorax. 13 patients had received surfactant treatment before pneumothorax. The primary diagnoses were respiratory distress syndrome (RDS) in 17 patients and transient tachypnea of the newborn (TTN) in 11 patients. 14 patients were resuscitated at birth. A thoracic tube was inserted in 22 patients, while 13 patients were followed up conservatively.

Conclusions: The most common predisposing causes in patients with pneumothorax are RDS and TTN. Early diagnosis and treatment of pneumothorax is life-saving. It should be kept in mind that pneumothorax may develop in patients who are followed up in the neonatal intensive care unit due to respiratory distress.

Keywords: Neonatal intensive care unit, neonate, pneumothorax

Copyright and license

Copyright © 2025 The Author(s). This is an open-access article published by Bolu İzzet Baysal Training and Research Hospital under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Aşık A, Akar S. Retrospective evaluation of cases with pneumothorax in our neonatal intensive care unit. Northwestern Med J. 2025;5(3):156-61. https://doi.org/10.54307/2025.NWMJ.139

References

  1. Zarogoulidis P, Kioumis I, Pitsiou G, et al. Pneumothorax: from definition to diagnosis and treatment. J. Thorac. Dis. 2014;6:S372-S376
  2. Park SW, Yun BH, Kim KA, Ko Sy, Lee YK, Shin SM. A clinical study about symptomatic spontaneous pneumothorax. Korean J Perinatol. 2006; 17: 304-9.
  3. Vibede L, Vibede E, Bendtsen M, Pedersen L, Ebbesen F. Neonatal pneumothorax: a descriptive regional Danish study. Neonatology. 2017; 111(4): 303-8. https://doi.org/10.1159/000453029
  4. Cattarossi L, Copetti R, Brusa G, Pintaldi S. Lung ultrasound diagnostic accuracy in neonatal pneumothorax. Can Respir J. 2016; 2016: 6515069. https://doi.org/10.1155/2016/6515069
  5. Liu J, Chi JH, Ren XL, et al. Lung ultrasonography to diagnose pneumothorax of the newborn. Am J Emerg Med. 2017; 35(9): 1298-302. https://doi.org/10.1016/j.ajem.2017.04.001
  6. Jhaveri V, Vali P, Giusto E, Singh Y, Lakshminrusimha S. Pneumothorax in a term newborn. J Perinatol. 2024; 44(4): 465-71. https://doi.org/10.1038/s41372-024-01899-2
  7. Sabour S. Ultrasound of pneumothorax in neonates: diagnostic value of the anterior transverse plane and of mirrored ribs; methodological issues. Pediatr Pulmonol. 2022; 57(9): 2257-8. https://doi.org/10.1002/ppul.25977
  8. Litmanovitz I, Carlo WA. Expectant management of pneumothorax in ventilated neonates. Pediatrics. 2008; 122(5): e975-9. https://doi.org/10.1542/peds.2008-1269
  9. Malek A, Afzali N, Meshkat M, Yazdi NH. Pneumothorax after mechanical ventilation in newborns. Iran J Pediatr. 2011; 21: 45-50.
  10. Bhatia R, Davis PG, Doyle LW, Wong C, Morley CJ. Identification of pneumothorax in very preterm infants. J Pediatr. 2011; 159(1): 115-20. https://doi.org/10.1016/j.jpeds.2010.12.016
  11. Apiliogullari B, Sunam GS, Ceran S, Koc H. Evaluation of neonatal pneumothorax. J Int Med Res. 2011; 39(6): 2436-40. https://doi.org/10.1177/147323001103900645
  12. Al Tawil K, Abu-Ekteish FM, Tamimi O, Al Hathal MM, Al Hathlol K, Abu Laimun B. Symptomatic spontaneous pneumothorax in term newborn infants. Pediatr Pulmonol. 2004; 37(5): 443-6. https://doi.org/10.1002/ppul.10447
  13. Trevisanuto D, Doglioni N, Ferrarese P, Vedovato S, Cosmi E, Zanardo V. Neonatal pneumothorax: comparison between neonatal transfers and inborn infants. J Perinat Med. 2005; 33(5): 449-54. https://doi.org/10.1515/JPM.2005.079
  14. Özbek AS, Kavuncuoğlu S, Ugan Atik S, Aldemir EY, Payaslı M, Sander S. Investigation of cases followed up with the diagnosis of pneumothorax in the neonatal intensive care unit between 2004-2008. Journal of Gynaecology Obstetrics Pediatrics and Pediatric Surgery. 2011: 3(2): 79-85.
  15. Akdoğan Z, Ovalı F, Samancı N, Dağoğlu T, Boneval C, Aksöyek S. Frequency of pneumothorax in newborns with respiratory distress. Türkiye Klinikleri Pediatri Dergisi. 1996; 5: 68-71.
  16. Ali R, Ahmed S, Qadir M, Maheshwari P, Khan R. Pneumothoraces in a neonatal tertiary care unit: case series. Oman Med J. 2013; 28(1): 67-9. https://doi.org/10.5001/omj.2013.16
  17. Alice Z, Gündogdu G, Kara C, Ilikkan B, Celayir S. Which patients are at risk? Evaluation of the morbidity and mortality in newborn pneumothorax. Indian Pediatr. 2003; 40: 325-8.
  18. Aly H, Massaro A, Acun C, Ozen M. Pneumothorax in the newborn: clinical presentation, risk factors and outcomes. J Matern Fetal Neonatal Med. 2014; 27(4): 402-6. https://doi.org/10.3109/14767058.2013.818114
  19. Kolås T, Saugstad OD, Daltveit AK, Nilsen ST, Øian P. Planned cesarean versus planned vaginal delivery at term: comparison of newborn infant outcomes. Am J Obstet Gynecol. 2006; 195(6): 1538-43. https://doi.org/10.1016/j.ajog.2006.05.005
  20. Jovandaric MZ, Milenkovic SJ, Dotlic J, et al. Neonatal pneumothorax outcome in preterm and term newborns. Medicina (Kaunas). 2022; 58(7): 965. https://doi.org/10.3390/medicina58070965
  21. Çördük N, Ürey T, Küçüktaşçı K, et al. Evaluation of newborn with pneumothorax. Pamukkale Medical Journal. 2014; 7(1): 47-51.
  22. Türkmen M, Tanmış AÇ, Etensel B, Özkısacık S, Akdilli A, Gürsoy H. Evaluation of cases with pneumothorax followed in the neonatal unit. Journal of Adnan Menderes University Faculty of Medicine. 2010: 11(1): 31-4.
  23. Navaei F, Aliabadi B, Moghtaderi M, Kelishadi R. Predisposing factors, incidence and mortality of pneumothorax in a neonatal intensive care unit in Isfahan, Iran. Chinese Journal of Contemporary Pediatrics. 2010; 12(6): 417-20.
  24. Thomas NH, Anthony C, Alfred LG, Alicia AM. Principles of respiratory monitoring and therapy. In: Taeusch W, Ballard R, Gleason C, editors. Avery’s Diseases of the Newborn. 8th ed. Philadelphia: Elsevier Saunders; 2005: 662-3.