Prem Arora1, Vaneet Kumar Kalra, Girija Natarajan. 1. Division of Neonatal-Perinatal Medicine, The Carman and Ann Adams Department of Paediatrics, Wayne State University School of Medicine, Detroit Medical Center, Children's Hospital of Michigan and Hutzel Women's Hospital, Detroit, MI 48201, USA. parora@dmc.org
Abstract
OBJECTIVE: To describe the clinical characteristics and outcomes of neonatal intensive care unit patients with a radiographic diagnosis of pneumatocele. STUDY DESIGN: Retrospective chart review. RESULTS: Our cohort (n = 27) had a gestational age of 27 ± 5 weeks, birth weight of 1038 ± 760 g, and a predominance of females (59%) and black infants (74%). All infants were ventilated at the time of diagnosis at a median age of 12 days (range: 5 to 105 days). Endotracheal cultures sent from 25 infants revealed bacteria in 20 (80%). Clinical diagnosis of pneumonia was made in 18 (67%) infants. Pneumatoceles resolved in 17 (63%) infants, but persisted in 10 (37%) infants. Compared with infants with resolution of pneumatoceles, mortality (70% versus 0%, p < 0.001), positive endotracheal cultures (100% versus 67%, p = 0.05), and clinical diagnosis of pneumonia (100% versus 47%, p = 0.005) were significantly higher in infants with persistent pneumatoceles. CONCLUSIONS: In infants with pneumatoceles, positive endotracheal culture is a frequent finding and correlates with persistence. Persistence of pneumatoceles is associated with a higher mortality. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: To describe the clinical characteristics and outcomes of neonatal intensive care unit patients with a radiographic diagnosis of pneumatocele. STUDY DESIGN: Retrospective chart review. RESULTS: Our cohort (n = 27) had a gestational age of 27 ± 5 weeks, birth weight of 1038 ± 760 g, and a predominance of females (59%) and black infants (74%). All infants were ventilated at the time of diagnosis at a median age of 12 days (range: 5 to 105 days). Endotracheal cultures sent from 25 infants revealed bacteria in 20 (80%). Clinical diagnosis of pneumonia was made in 18 (67%) infants. Pneumatoceles resolved in 17 (63%) infants, but persisted in 10 (37%) infants. Compared with infants with resolution of pneumatoceles, mortality (70% versus 0%, p < 0.001), positive endotracheal cultures (100% versus 67%, p = 0.05), and clinical diagnosis of pneumonia (100% versus 47%, p = 0.005) were significantly higher in infants with persistent pneumatoceles. CONCLUSIONS: In infants with pneumatoceles, positive endotracheal culture is a frequent finding and correlates with persistence. Persistence of pneumatoceles is associated with a higher mortality. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.