Neonatal pneumothorax: Implications and prognosis

The authors present data of 20 neonates with pneumothorax in a Level II neonatal intensive care unit over seven year period with the objective of understanding etiology, course and outcome. 55% were term and 30% preterm with mean birth weight of 2264 grams. Pneumothorax was predominantly right-sided. Underlying etiology included pneumonia and sepsis, hyaline membrane disease, and meconium aspiration syndrome. The mean age in hours at the time of diagnosis of pneumothorax was 88.25 and was not statistically significant for the ventilated preterm (73.5 hours) and term (95.14 hours) neonates. 80% required positive pressure ventilation post-pneumothorax. There was recurrence and other air-leaks in 15%. In a significant 80%, diagnosis was radiological. 75% required inter-costal chest tube drainage. Mortality was seen in 40%. Prematurity, low birth weight, primary lung pathology, and positive pressure ventilation were important determinants of neumothorax, with mortality directly related to the primary etiology and other co-morbid conditions.