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Pulmonary Medicine
Volume 2014 (2014), Article ID 727323, 4 pages
http://dx.doi.org/10.1155/2014/727323
Clinical Study

Frequency and Intensive Care Related Risk Factors of Pneumothorax in Ventilated Neonates

Department of Paediatrics, Kasturba Medical College, Manipal University, Manipal, Udupi District, Karnataka 576104, India

Received 13 November 2013; Revised 25 March 2014; Accepted 7 April 2014; Published 28 April 2014

Academic Editor: Dimitris Georgopoulos

Copyright © 2014 Ramesh Bhat Yellanthoor and Vidya Ramdas. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. Relationships of mechanical ventilation to pneumothorax in neonates and care procedures in particular are rarely studied. We aimed to evaluate the relationship of selected ventilator variables and risk events to pneumothorax. Methods. Pneumothorax was defined as accumulation of air in pleural cavity as confirmed by chest radiograph. Relationship of ventilator mode, selected settings, and risk procedures prior to detection of pneumothorax was studied using matched controls. Results. Of 540 neonates receiving mechanical ventilation, 10 (1.85%) were found to have pneumothorax. Respiratory distress syndrome, meconium aspiration syndrome, and pneumonia were the underlying lung pathology. Pneumothorax mostly (80%) occurred within 48 hours of life. Among ventilated neonates, significantly higher percentage with pneumothorax received mandatory ventilation than controls (70% versus 20%; ). Peak inspiratory pressure >20 cm and overventilation were not significantly associated with pneumothorax. More cases than controls underwent care procedures in the preceding 3 hours of pneumothorax event. Mean airway pressure change ( ) and endotracheal suctioning ( ) were not significantly associated with pneumothorax. Reintubation ( ), and bagging ( ) were significantly associated with pneumothorax. Conclusion. Pneumothorax among ventilated neonates occurred at low frequency. Mandatory ventilation and selected care procedures in the preceding 3 hours had significant association.