A P Ainsworth1, A R Ruager, E Holtved. 1. Odense Universitetshospital, thoraxkarkirurgisk afdeling T og paediatrisk afdeling H. alan.ainsworth@dadlnet.dk
Abstract
INTRODUCTION: Neonatal pneumothorax (NP) is associated with an increased mortality. However, few studies have evaluated which parameters are associated with neonatal death and infant death. METHODS: Retrospective study of newborns treated for NP at a university hospital in the period 1.1.1989 to 31.12.1998. RESULTS: Forty-seven newborns (30 boys, 17 girls) had NP. Thirty-two infants (68%) had chest tube insertion, and 15 (32%) did not need chest tube. Nine infants (19%) died within one week after birth. Six of these were mature infants with additional major congenital malformations. The remaining three were premature infants with gestational ages of 25, 26 and 29 weeks, respectively. Another 29 week old infant died during the first year of life, bringing the total number of deaths within one year to ten (21%). No deaths occurred among infants with NP who did not have chest tube insertion. Apart from the presence of additional major congenital malformations (p = 0.001/0.003) and the need for mechanical ventilation after tube insertion (p = 0.058/0.035) none of the selected parameters (sex, birth weight, gestational age, way of delivery, CPAP treatment before tube insertion, mechanical ventilation before tube insertion, uni or bilateral pneumothorax, and total number of tubes) had significant relationship to neonatal death or infant death. DISCUSSION: The presence of additional congenital malformations and the need for mechanical ventilation after tube insertion were the only parameters in this series which were associated with an increased mortality in infants with NP demanding tube drainage.
INTRODUCTION: Neonatal pneumothorax (NP) is associated with an increased mortality. However, few studies have evaluated which parameters are associated with neonatal death and infant death. METHODS: Retrospective study of newborns treated for NP at a university hospital in the period 1.1.1989 to 31.12.1998. RESULTS: Forty-seven newborns (30 boys, 17 girls) had NP. Thirty-two infants (68%) had chest tube insertion, and 15 (32%) did not need chest tube. Nine infants (19%) died within one week after birth. Six of these were mature infants with additional major congenital malformations. The remaining three were premature infants with gestational ages of 25, 26 and 29 weeks, respectively. Another 29 week old infant died during the first year of life, bringing the total number of deaths within one year to ten (21%). No deaths occurred among infants with NP who did not have chest tube insertion. Apart from the presence of additional major congenital malformations (p = 0.001/0.003) and the need for mechanical ventilation after tube insertion (p = 0.058/0.035) none of the selected parameters (sex, birth weight, gestational age, way of delivery, CPAP treatment before tube insertion, mechanical ventilation before tube insertion, uni or bilateral pneumothorax, and total number of tubes) had significant relationship to neonatal death or infant death. DISCUSSION: The presence of additional congenital malformations and the need for mechanical ventilation after tube insertion were the only parameters in this series which were associated with an increased mortality in infants with NP demanding tube drainage.