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. 2017 Dec 22;43(1):114.
doi: 10.1186/s13052-017-0436-y.

Management of pneumothorax in hemodynamically stable preterm infants using high frequency oscillatory ventilation: report of five cases

Claudia Aurilia  1 , Cinzia Ricci  1 , Milena Tana  1 , Chiara Tirone  1 , Alessandra Lio  1 , Alessandro Gambacorta  1 , Angela Paladini  1 , Giovanni Vento  2
Affiliations

Management of pneumothorax in hemodynamically stable preterm infants using high frequency oscillatory ventilation: report of five cases

Claudia Aurilia et al. Ital J Pediatr. .

Abstract

Background: Despite an increased use of non-invasive ventilatory strategies and gentle ventilation, pneumothorax remains a common complication in preterm infants. The ventilator management of infants with air leaks remains challenging in terms of both prevention and treatment. Recently the safety and efficacy of expectant management avoiding chest tube drainage to treat large air leak in preterm infants hemodynamically stable has been reported.

Case presentation: In the present study, we report five cases of preterm infants with birth weight ≤ 1250 g affected by respiratory distress syndrome and treated with nasal continuous positive airway pressure as first intention. They were intubated for worsening of respiratory distress with increasing oxygen requirement and concomitant increase of respiratory rate and PCO2 values due to occurrence of pneumothorax, and they were successfully treated using high-frequency oscillatory ventilation without chest tube insertion.

Conclusion: In our experience high-frequency oscillatory ventilation provided a conservative management of a significant pneumothorax in preterm newborns hemodynamically stable and requiring mechanical ventilation. This approach allowed us to avoid the increasing of air leak and the insertion of chest tube drainage and all the subsequent associated risks.

Keywords: Chest drainage; HFOV; Pneumothorax; Preterm infants.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Ethics Committee of the Policlinico Universitario A. Gemelli-Università Cattolica del S. Cuore, Rome.

Consent for publication

Written informed consent was obtained from the parents of the patients for publication of this cases report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Chest X Rays of patient 1 and patient 4. Legend: patient 1: a: left side pneumothorax. b: resolution of pneumothorax 48 h later; patient 4: c: right side pneumothorax. d: resolution of pneumothorax 48 h later
See this image and copyright information in PMC

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References

    1. Jeng MJ, Lee YS, Tsao PC, Soong WJ. Neonatal air leak syndrome and the role of high-frequency ventilation in its prevention. J Chin Med Assoc. 2012;75:551–559. doi: 10.1016/j.jcma.2012.08.001. - DOI - PubMed
    1. Ratchada K, Rahman A, Pullenayegum EM, Sant’Anna GM. Positive airway pressure levels and pneumothorax: a case-control study in very low birth weight infants. J Matern Fetal Neonatal Med. 2011;24:912–916. doi: 10.3109/14767058.2010.535877. - DOI - PubMed
    1. Migliori C, Campana A, Cattarelli D, Pontiggia F, Chirico G. Pneumothorax during nasal-CPAP: a predictable complication? Pediatr Med Chir. 2003;25:345–348. - PubMed
    1. Kitsommart R, Martins B, Bottino MN, Sant’Anna GM. Expectant management of pneumothorax in preterm infants receiving assisted ventilation: report of 4 cases and review of the literature. Respir Care. 2012;57:789–793. - PubMed
    1. Litmanovitz I, Carlo WA. Expectant management of pneumothorax in ventilated neonates. Pediatrics. 2008;122:e975–e979. doi: 10.1542/peds.2008-1269. - DOI - PubMed

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