Objective: To assess the differences in clinical characteristics, management and outcome between the neonatal transfers and inborn neonates with pneumothorax.
Methods: The records of 36 neonatal transfers (Group A) and 25 inborn (Group B) neonates with symptomatic pneumothorax were retrospectively analyzed.
Results: In Group A, gestational age (36±2 vs. 31±4 weeks; P<0.01), birth weight (2720±537 vs. 1736±1028 g; P<0.01), exclusive oxygen-therapy before the event (47% vs. 20%; P<0.05) and tube thoracostomy (78% vs. 44%; P<0.05) were significantly higher than in Group B. The need of resuscitation at birth (19% vs. 44%; P<0.05), conventional mechanical ventilation (20% vs. 56%; P<0.05), presence of associated major congenital malformations (0% vs. 20%; P<0.01), length of hospital stay (9±6 vs. 32±32 days; P=0.01) and mortality (0% vs. 16%; P=0.01) were significantly lower in Group A than in Group B.
Conclusions: Neonatal transfers and inborn neonates with pneumothorax have different clinical characteristics and outcome. This information could be useful for all persons involved in the interhospital care of perinatal patients.
1 Anonymous: Interhospital care of the perinatal patient. In: Guidelines for perinatal care. American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, Washington DC 1997Search in Google Scholar
2 Chernic V, ME Avery: Spontaneous alveolar rupture at birth. Pediatrics32 (1963) 816Search in Google Scholar
3 Davis CH, GW Stevens: Value of routine radiographic examinations of the newborn, based on a study of 702 babies. Am J Obstet Gynecol20 (1930) 73Search in Google Scholar
4 Fenton AC, A Leslie, CH Skeock: Optimising neonatal transfer. Arch Dis Child Fetal Neonatal Ed89 (2004) F21510.1136/adc.2002.019711Search in Google Scholar PubMed PubMed Central
5 Hodson WA: Normal and abnormal structural development of the lung. In: Polin RA and WW Fox: Fetal and neonatal physiology. WB Saunders Company, Philadelphia 1998Search in Google Scholar
6 Korones SB: Complications: bronchopulmonary dysplasia, air leak syndromes, and retinopathy of prematurity. In: Goldsmith JP, EH Karotkin: Assisted ventilation of the neonate. WB Saunders Company, Philadelphia 1996Search in Google Scholar
7 McIntosh N, JC Becher, S Cunningham, B Stenson, IA Laing, AJ Lyon, P Badger: Clinical diagnosis of pneumothorax is late: use of trend data and decision support might allow preclinical detection. Pediatr Res48 (2000) 408Search in Google Scholar
8 Ogata ES, GA Gregory, JA Kitterman, RH Phibbs, WH Tooley: Pneumothorax in respiratory distress syndrome: incidence and effect on vital signs, blood gases and pH. Pediatrics58 (1976) 177Search in Google Scholar
9 Roy RND: Training an educational needs in neonatal transport. In: Mir NA: Manual of neonatal transport. British Library Cataloguing-in-Publishing Data, Manchester 1997Search in Google Scholar
10 Swift J: Thoracentesis and thoracostomy tubes. In: Taeusch HW, RO Christiansen, ES Buescher: Pediatric and neonatal tests and procedure. WB Saunders Company, Philadelphia 1996Search in Google Scholar
11 Watkinson M, I Tiron: Events before the diagnosis of a pneumothorax in ventilated neonates. Arch Dis Child Fetal Neonatal Ed85 (2001) F20110.1136/fn.85.3.F201Search in Google Scholar
12 Zanardo V, AK Simbi, M Franzoi, G Solda, Salvadori A, Trevisanuto D: Neonatal respiratory morbidity risk and mode of delivery at term: influence of timing of elective caesarean delivery. Acta Paediatr93 (2004) 643Search in Google Scholar
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