Post-extubation atelectasis in ventilated newborn infants.

Post-extubation atelectasis (PEA) constitutes the commonest cause of lung collapse in ventilated neonates. The clinical and radiological features of 47 ventilated infants who developed PEA within 24 h of extubation are reported. Three main radiographic patterns of atelectasis were identified: (1) transient unilobar collapse resolving within 12 h of extubation (19 cases), (2) multilobar atelectasis developing over a 48-h period (18 cases), and (3) progressive atelectasis resulting in complete collapse of a whole lung. A similar number of ventilated infants without PEA served as controls. We found a significant association between the incidence of PEA and multiple intubation (P < 0.02), presence of patent ductus arteriosus (P < 0.001) and neonatal sepsis (P < 0.05). Prophylactic physiotherapy is recommended for ventilated infants, particularly those with the above risk factors.